This is the first edition of this guideline.
Approximately 250 000 women undergo laparoscopic surgery in the UK each year. The majority are without problems but serious complications occur in about one in 1000 cases. Laparoscopic injuries frequently occur during the blind insertion of needles, trocars and cannulae through the abdominal wall and, hence, the period of greatest risk is from the start of the procedure until visualisation within the peritoneal cavity has been established. This guideline aims to highlight strategies to reduce these complications.
Over the past 50 years, developments in electronic and optical technologies have meant that it has become possible to perform many gynaecological operations laparoscopically. The unique feature distinguishing laparoscopic from open abdominal or vaginal surgery is the need to insert needles, trocars and cannulae for initial entry into the abdomen. This may result in bowel or vascular injury. There is wide variation in the techniques used by laparoscopic surgeons and this guideline concentrates the evidence for different entry techniques. One of the difficulties of bowel damage associated with laparoscopic surgery is the likelihood that it may not be immediately recognised and could present some time later, often after discharge from hospital. This potentially serious complication may require major abdominal reparative surgery and sometimes a temporary colostomy. It is essential, therefore, that women and attending staff understand that the recovery from laparoscopic procedures is usually rapid and, where this is not the case, that early diagnosis and treatment are essential and should involve senior medical staff . The relative infrequency of these accidents prevents any individual laparoscopic surgeon from gaining a true appreciation of their importance or frequency.
This guideline can be downloaded as a pdf using the link below.