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Cited by 418Minimally Invasive Surgical TechniquesGynecological conditions and treatmentsUterine Myomas and Treatments

Surgical complications of diagnostic and operative gynaecological laparoscopy: a series of 29,966 cases

Chapron, C., Querleu, D., Bruhat, M. A., Madelenat, P., Fernandez, H., Pierre, F., Dubuisson, J. B.·1998·Human Reproduction
DOI 10.1093/humrep/13.4.867
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Abstract

A multicentre study was carried out in seven top French centres for laparoscopic gynaecological surgery. This series covers a period of 9 years, in which 29,966 diagnostic and operative laparoscopic operations were performed. The risk of complications has been assessed according to the complexity of the laparoscopic procedure in question. The means of diagnosis and treatment of the complications have been analysed, together with the importance of the surgeon's degree of experience. The mortality rate was 3.33 per 100,000 laparoscopies. The overall complication rate was 4.64 per 1000 laparoscopies (n = 139). The rate of complications requiring laparotomy was 3.20 per 1000 (n = 96). The complication rate was significantly correlated with the complexity of the laparoscopic procedure (P = 0.0001). One in three complications (34.1%; n = 43) occurred while setting up for laparoscopy, and one in four (28.6%) were not diagnosed during the operation. As new indications for laparoscopic surgery in gynaecology have appeared, there has been a parallel and statistically significant increase in the rate of urological complications (P = 0.001). Increased experience by the surgeons has had three consequences: a statistically significant drop in the number of bowel injuries (P = 0.0003), a drop in the rate of complications requiring laparotomy for those laparoscopic surgical procedures that are well defined (P = 0.01), and a change in the way complications are treated, with a significant increase in the proportion of incidents treated by laparoscopy (P = 0.0001).

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Crossref · 10.1093/humrep/13.4.867

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  • There is no evidence of superiority of diagnostic laparoscopy compared to empirical medical treatment for symptom management in women suspected of endometriosis.

    “As there is no evidence of superiority of either approach (Chapron et al., 1998; Byrne et al., 2018; Bafort et al., 2020), the GDG concluded that both diagnostic laparoscopy and imaging combined with empirical treatment (hormonal contraceptives or progestogens) can be considered in women suspected of endometriosis.”

    From ESHRE guideline: endometriosis (2022) · cites this paper as Chapron et al., 1998

  • In a large multicenter French study (n=29,966), diagnostic and therapeutic laparoscopy were associated with a 3.3 per 100,000 mortality and a 4.6 per 1000 morbidity risk.

    “In a large multicenter French study (n ¼ 29 966), diagnostic and therapeutic laparoscopy were found to be associated with a 3.3 per 100 000 mortality and a 4.6 per 1000 morbidity risk.17”

    From Defining Future Directions for Endometriosis Research: Workshop Report From the 2011 World Congress of Endometriosis in Montpellier, France (2013) · cites this paper as [17]

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Authors
Chapron, C., Querleu, D., Bruhat, M. A., Madelenat, P., Fernandez, H., Pierre, F., & Dubuisson, J. B.
Affiliations
Hôpital Cochin (FR)
ORCID
Venue
Human Reproduction
Publisher
Oxford University Press (OUP)
Published
1998-04-01
Volume
13
Issue
4
Pages
867-872
ISSN
  • 0268-1161 (ISSN-L)
  • 1460-2350
DOI
10.1093/humrep/13.4.867
OpenAlex
W2165936652
Cited by
406
References
0
Citations by year
2026: 4 · 2025: 9 · 2024: 4 · 2023: 17 · 2022: 10 · 2021: 12 · 2020: 12 · 2019: 9 · 2018: 17 · 2017: 7 · 2016: 15 · 2015: 16 · 2014: 17 · 2013: 22 · 2012: 24
FWCI
19.98
Type
journal article
Language
en
Open access
closed
Locations
  • Human Reproduction (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Minimally Invasive Surgical Techniques
  • Health Sciences › Medicine › Obstetrics and Gynecology › Gynecological conditions and treatments
  • Health Sciences › Medicine › Obstetrics and Gynecology › Uterine Myomas and Treatments
Keywords
gynecologic laparoscopy, surgical complications, diagnostic laparoscopy, laparoscopic surgery, complication incidence, procedure complexity, surgeon experience, postoperative mortality, intestinal injury, urological complications, laparotomy, complication management
MeSH terms
Female, Genital Diseases, Female, Humans, Intraoperative Complications, Laparotomy, Laparoscopy, Reoperation, Incidence

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