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  • Title: Laparoscopy: a retrospective study with two or more years follow-up of patients in a small community hospital.
    Author: Chapman JD.
    Journal: J Am Osteopath Assoc; 1982; 81(6 Suppl):429-35. PubMed ID: 6210647.
    Abstract:
    The study purpose was to assess the value of laparoscopy in a small community hospital (Northeastern Ohio General Hospital) with 1 operator utilizing the procedure and to examine its complications, failures, and problems. 518 laparoscopies were performed over the August 1972 to November 1975 period. 93% of the procedures (484 patients) were for interval sterilization. 4% (18 patients) were for diagnostic purposes, and 3% (16 patients) were for infertility. The surgical technique utilized throughout most of the study was a single puncture method using the Jacobs-Palmer operating laparoscope. Study results are derived from analysis of 3 different factors. The 1st part of the study was carried out to collect the data on the population in general, and this was acquired from a review of the hospital charts. The 2nd segment was the 3 week and 6 week office follow-up reviews of the patients and their problems. The 3rd part was the longterm follow-up in which patients returned for routine gynecologic care. There were 5 failures of the procedure in this study, or 10/1000. There have been no cases of delayed postoperative bleeding. All bleeding that was identified was seen at the time of the surgery and managed at that point. There were no deaths in this series. The following side effects were found in longterm follow-up. This consisted of 376 patients. 3% (15 patients) had delayed menses after the surgery, which appeared to be associated with longterm use of oral contraceptives, 6% (30 patients) had amenorrhea for more than 75 days postoperatively. 22 patients (5.5%) had hypomenorrhea within the 1st 2 years postoperatively. 5% (25 patients) had a discharge from catgut suture while less than 1% had an umbilical difficulty or discharge from the Dexon suture. 18 patients (3.6%) of the population had postoperative dysuria within the 1st month. Delayed pain, dysmenorrhea, or dysparenuia within the 1st 2 years was detected in 2.5% (12) of the total population but could not be totally explained on a physiologic or anatomic basis. 7 patients (1.2%) had sexual anhedonia. There were 3 hysterectomies carried out subsequent to laparoscopic sterilization. The report of the Complications Committee of the American Association of Gynecologic Laparoscopists is reviewed. In this series the major difficulties or complications encountered in laparoscopy have not been observed. This is due in part to the training of the individual operator but also to a team effort at this hospital.
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