Death after gynae surgery is very rare but sadly it happens. Who expects adverse events in routine ‘tests’ and procedures? It barely rates as proper surgery. Many of my clients, especially doctors, are proud to get back to work within hours of a ‘Lap and Dye,’ focused purely on awaiting results.
I believe surgery and anaesthesia, no matter how neat or cute-sounding, need to be taken seriously. Laparoscopy is a great way to check those bits involved in the baby-making chain. A camera is inserted via a tiny incision close to the belly button. Gas is blown in to expand the tightly packed area for better viewing quickly diffuses. Wounds are tiny with the resulting scar nearly invisible after healing. Home on the same day with a couple of panadol for windy pains is all that’s needed.
More than a test
Laparoscopic surgery is used for endometriosis removal, ovarian cysts, pelvic pain, ectopic pregnancy, hysterectomy and tubal ligation.
Major complications and death are rare afterwords and women feel safe. Sadly complications leading to death can, and do happen, as a sobering study shows.
Lap and Dye – fatal outcomes
Dr Gerald Lawson reviewed the cases of 18 Australian who women died following gynae laparoscopic interventions in the Australian and New Zealand Journal of Obstetrics and Gynaecology.
Complications leading to death include 10 bowel perforations, 5 perforations of major blood vessels, 1 bladder tear and 1 necrotising fasciitis – both causing septicaemia and 1 pulmonary embolism.
According to gynaecologist and surgeon Dr. Andreas Obermair only two bowel injuries were quickly recognised. The length of time before diagnosis in the unrecognised cases was three and a half days. Where the bowel damage was misdiagnosed X-ray and CT scans reported normal findings.
Six of the women were home before symptoms set in.
Bowel can become displaced and trapped behind the peritoneum causing infection and cardiac arrest according to Jos Vollebergh at Ziekenhaus Bernhoven.
What to look out for
Signs that something is amiss include: Abdominal pain, rapid breathing, nausea, vomiting, diarrhoea, low urinary output, faintness, and collapse.* If you’re not smiling on Day 2 something may be wrong – you shouldn’t ignore any discomfort or gut feelings.
Researchers recommend:
- Patients arriving in A & E with *post laparoscopy symptoms should be taken seriously and regarded as having a severe surgical injury until proven otherwise.
- All laparoscopic surgeons should be trained in recognising and treating vascular and perforation injuries and should have a network of friendly colleagues available.
- Delay in diagnosis increases the danger.
- A repeat laparoscopy, even with the absence of positive imaging findings would reassure the surgeon about the absence of damage.
Dr Obermair adds, ‘In my experience the likelihood of severe surgical complication is greatest in the first week after surgery. I make every effort to see my patients at 1-2 weeks as opposed to 6 weeks.’ He recommends patients remain within an hour’s drive of the hospital to have a realistic chance to fix problems. If the patient would be in a remote area the time to get her back into the big city, the time to organise transport could be too long and cost her life.’
Infertility investigations and procedures aren’t a competition to see who brushes them off quickest. Why not take time to let your body recover?
The international register of surgical events is www. performance.com
For more information head over to my Website … come follow me on Facebook & Twitter
