Complications in laparoscopic intestinal surgery: prevention and management.

Laparoscopic surgery is rapidly becoming the standard of care for many intestinal disorders. Intraoperative complications of laparoscopic intestinal surgery have been described to occur in 4-16% of procedures, although definitions vary widely across reports. Complications associated with first trocar insertion, although rare, can be fatal. The use of an open insertion technique is strongly recommended. Other intraoperative complications associated with laparoscopic intestinal surgery include cautery injuries, vascular injuries and hemorrhage, bowel injuries, bladder and ureteric injuries as well as missed or delayed injuries. Physiolo-gical complications of laparoscopy include pneumoperitoneum-specific complications, cardiopulmonary complications, and position-related complications. Finally, injury to the surgeon can occur, from which the field of surgical ergonomics has been derived.