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Although laparoscopic surgery causes less tissue damage than open surgery, as with any surgical procedure, there is a risk of complications. Although many of these complications are minor and easily dealt with, they arise in 1-5 percent of all laparoscopic surgeries, and the fatality rate for laparoscopy complications is about 0.05 percent. Some of the most common complications arise from an adverse reaction to anesthesia, which can include respiratory complications and cardiac arrhythmia. Other common laparoscopy complications include infection, pneumonia, bronchitis, excessive bleeding and the formation of scar tissue. These complications can occur following either open surgery or laparoscopic surgery but are less common after laparoscopy.
Laparoscopic surgery might result in injury to the bowel, abdominal organs, veins and arteries. Inexperienced surgeons might inadvertently perforate the intestines or other parts of the gastrointestinal tract with the long, pointed surgical instruments that they use. Although these injuries are uncommon, they can lead to a potentially dangerous condition called peritonitis, which is the inflammation of the peritoneum. In some cases, a further operation using a larger incision is necessary to repair damaged tissue or stop bleeding.
Patients can also suffer unobserved electrical burns caused by electrodes that pass current into surrounding tissue. These burns can lead to peritonitis. Active electrode monitoring eliminates the risk of inadvertent internal electrical burns.
Patients who have blood coagulation disorders or have developed scar tissue as a result of earlier surgeries are at greater risk for laparoscopy complications. Patients who have below-average body mass indexes are also at a greater risk. Their surgeons might opt to perform open surgery instead, because of these factors.
The carbon dioxide gas that is used to inflate the abdominal cavity during surgery can also cause laparoscopy complications. Cold, dry gas might cause hypothermia and peritoneal trauma. This risk is reduced by humidifying and warming the carbon dioxide gas.
Patients who have respiratory disorders might not tolerate the expansion of the abdominal cavity using carbon dioxide, necessitating open surgery instead. A further complication is caused by carbon dioxide gas remaining in the abdominal cavity following surgery. A pocket of gas might rise in the abdomen and press against the diaphragm, causing pain when the patient breathes. This usually is a temporary condition alleviated when body tissues absorb the excess gas.
An incisional bowel herniation is another potentially serious laparoscopy complication that results from improperly closing off the sites of ports larger than 0.4 inches (10 mm) used to introduce surgical instruments during the operation. It is critical that the fascia be properly closed. Symptoms of bowel herniation include intermittent nausea and vomiting.
Infection are is another common laparoscopy complication. In the case of an infection, an antibiotic is usually administered. To avoid laparoscopy complications, some surgeons prescribe antibiotics in advance of surgery when there is a heightened risk of infection because of the patient's insufficient immune response.
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