Complications of Laparoscopic Minimally Invasive Surgery

Abstract

Introduction: Reports of complications during pediatric laparoscopic procedures are seldom found in the international literature. The aim of this paper is to provide an overview of the complications of laparoscopic minimally invasive surgery (MIS) in children and their management.Methods: The authors analyzed the results of their 10 years of experience in pediatric laparoscopic surgery, in addition to the data on this topic found in the international literature.Results: The incidence of complications occurring during laparoscopic MIS appears to be about 5%. In about 70% of cases, the complications can be managed laparoscopically, whereas in 30% of cases, a conversion to open surgery is required. Complications related to use of the Veress needle or placement of the first trocar are rare thanks to the routine use of open laparoscopy; other types of complications appear to be related to the experience of the surgeon, especially in suturing and intracorporeal knot tying. In an increasing number of cases, so-called technical complications appear to be related to the failure of laparoscopic equipment or other instruments and devices.Conclusions: The authors believe that the routine use of open laparoscopy in children is a key factor to avoiding the complications related to use of the Veress needle and blind introduction of the first trocar. Moreover, the surgeon's laparoscopic experience, the correct indications for laparoscopic surgery, and verification of the laparoscopic equipment before surgery are important in reducing the incidence of complications. It is preferable for an inexperienced surgeon to have the assistance of an expert laparoscopic surgeon to decrease the number of complications related to the learning curve.

Laparoscopic Surgeries in Pediatric Abdominal Surgical Emergencies

“…Это основополагающий момент, который позволяет вначале предупредить, а затем быстро и безопасно ликвидиро-вать возникшее осложнение при лапароскопической операции. Частота осложнений во время выполнения лапароскопических манипуляций у детей колеблется от 4 до 5%, в большинстве случаев с ними получается справиться лапароскопически [61][62][63]. Причины ослож-нений могут быть обусловлены минимальным доступом по сравнению с открытыми оперативными вмешатель-ствами.…”