Major surgical complications of laparoscopy.

During the 15-yr period from 1965 to 1979, 6 major surgical complications were encountered among 2757 consecutive laparoscopies, yielding a rate of 2.1 per 1000. Five of the complications required exploratory laparotomy (in 2 patients with small bowel perforations, 2 patients with intraabdominal bleeding and 1 patient with severe peritonitis). In the 6th patient perforation of the uterine fundus occurred during laparoscopy performed because the presence of an adnexal mass was suspected at 15 wk gestation. Laparotomy in this patient was not performed since bleeding from the perforation site stopped spontaneously. Exploratory laparotomy rather than laparoscopy should be considered for evaluation of pelvic masses suspected after the first trimester of pregnancy. A small rate of major surgical complications of laparoscopy is to be expected even when accurate technique is used.