Intraoperative events and their outcome: data from 4007 laparoscopic interventions by the French "Club Cœlio"

Abstract

Aim: To assess the operative and postoperative course of intraoperative events occurring in laparoscopic surgery according to the classification of Clavien. This evaluation aims at ascertaining morbidity and mortality of abdominal laparoscopic operations, thus serving as a reference for future comparative studies.

Method: Twenty-nine senior surgeons, all of them members of the Cœlio Club prospectively and consecutively summarized all their laparoscopic activity over a period of 6 months.

Results: Of 4007 patients, 373 (9.31%) developed complications, 69 (1.72%) requiring surgery. Establishing the pneumoperitoneum and trocar placement caused 15 vascular (0.37%) and six visceral (0.15%) injuries; seven vascular (0.17%) and 22 visceral (0.55%) injuries occurred intraoperatively. Surgery of the colon and especially the rectum were associated with the highest morbidity with Clavien grades III, IV and V reported in 8, 10 and 15.97% of patients, respectively; 1.2% occurred in biliary surgery and 0.67% in inguinal/femoral hernia repair.

Conclusion: The prevalence of surgical intraoperative events and postoperative complications is higher than reported in the literature. Clavien's classification is applicable to abdominal laparoscopic surgery; further information is necessary to assess intraoperative surgical events as well as conversions.