Laparoscopy for the Detection and Treatment of Early Complications from Minimally Invasive Urologic Surgery

摘要

OBJECTIVE: To evaluate the role of laparoscopy for the detection and management of early postoperative complications after minimally invasive urologic surgery. PATIENTS AND METHODS: From October 2003 to September 2008, data were prospectively collected for all patients needing surgical intervention within 21 days after urologic minimally invasive procedures. No patients operated on for a postoperative complication during this period were excluded. Minimally invasive surgical intervention was performed on all hemodynamically stable patients in whom pneumoperitoneum could be established safely. RESULTS: A total of 1962 laparoscopic or robot-assisted urologic procedures were performed. In 14 (0.7%) cases, surgical intervention was necessary for postoperative complications. Two patients underwent exploratory laparotomy because of abdominal distention and hemodynamic instability. Laparoscopic surgical intervention successfully diagnosed and treated the remaining 12 patients. There were no conversions to open surgery. No additional trocars were necessary apart from preexisting sites. Two (14%) patients had minor postexploration complications. Mean estimated blood loss was 70 mL (range 50-100 mL). The mean length of hospital stay after exploration was 2 days (range 5 hours-5 days). CONCLUSIONS: With surgical expertise, laparoscopic treatment of intra-abdominal complications after minimally invasive urologic procedures can be successfully and safely performed. The advantages of the minimally invasive approach may be preserved.