Thermal dissection techniques in gynecological laparoscopy - a survey of use and complications in Germany (n=58 200)

Objective: Thermic dissection and tissue preparation using electric or laser energy have become a standard technique of endoscopic surgery. We review the use and complication rate of these techniques in Germany. Methods: 124 German hospitals were surveyed, looking at the years between 1996 to 1999. Questionnaires were sent, asking for basic data as well as specific information regarding interventions, thermic dissection techniques and complications. Results: With a return rate of 88.7%, a total of 58 200 surgical interventions were analysed, including all standard and advanced laparoscopic surgeries in gynecology. The reported rate of significant complications was low at 0.13%. Bowel injury was the most common adverse event, followed by postoperative hemorrhage, intraoperative hemorrhage and injuries of the ureters and bladder. Conclusion: Thermal dissection techniques are used in all gynecologic laparoscopic surgical settings. Most commonly, electrocautery is used. Laser use is uncommon. Major complications directly related to thermal dissection techniques are rare.