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Surgical complications of diagnostic and operative gynaecological laparoscopy: a series of 29,966 cases
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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In the citing paper
“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 the citing paper
“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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Metadata
- Authors
- Chapron, C., Querleu, D., Bruhat, M. A., Madelenat, P., Fernandez, H., Pierre, F., & Dubuisson, J. B.
- Affiliations
- Hôpital Cochin (FR)
- 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
- 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
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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