Surgical complications - it is possible to prevent them
Epublication WebSurg.com, Jan 2012;12(01). URL: http://websurg.com/doi/lt03enwenger001
Complications after laparoscopic surgery for endometriosis may occur even with a skilled surgeon and ideal circumstances. Success is linked to many factors, and not only to the surgeon’s experience. It is necessary to inform the patient in order to avoid medico-legal problems. An appropriate diagnosis must be performed, including clinical examination and all other necessary investigations. Proper instruments, anatomical knowledge, and exposure help to prevent severe complications. Make sure that you visualize the ureters at the beginning of the surgery as they always tend to go medially. In addition, ureterosacral resection should be avoided in order to prevent bladder dysfunction. Always prefer discoid excision of the bowel rather than bowel resection and make sure the suture does not exceed 3cm on the bowel, and avoid any vertical suturing when possible. If there is a history of surgery or a lesion near the ostia or a ureteral stenosis, ureteral stents should be placed. At the end of the procedure, it is recommended to carry out a blue dye or an air test, a cystoscopy or to place drains. A postoperative consultation is essential.