What are the complications of Surgery?

All patients preparing for surgery need to be aware of the possible problems associated with surgical intervention. While conventional, open procedures carry a far higher rate of complications compared to laparoscopic surgery, between 2 to 4% of patients who undergo laparoscopic surgery nationwide will experience a complication. With any surgery performed under general anesthesia, there is a less than one in a thousand chance of severe complications from the anesthesia medications. There is a less than 1 in 500 possibility of severe bleeding that would require a blood transfusion. All surgeries carry the risk of infection, postoperative pneumonia or blood clots forming in the deep veins in the legs. These risks are reduced by the use of antibiotics, pneumatic stockings, and laparoscopic techniques, which allow the patient to be active more quickly after surgery.

There are complications specific to the surgery. Damage to organs such as the bowel, spleen or liver may occur. This may or may not be identified by the surgical team during surgery and could result in serious infection. These problems can usually be repaired at the time of laparoscopic surgery, or even on a second look using the laparoscope.

Occasionally it is not possible to complete the operation with the laparoscopic technique because of difficulty with visualization or because of complications. The national rate of conversion to open is reportedly 1-10%. The risk of death, inherent in any surgical procedure, is less than 1 in 600 nationally.

In our series of over 5000 procedures, we have given no blood transfusions, have had no deaths during surgery, or during the postoperative period. Two deaths in our group were cardiac related, not associated with surgery and occurred after surgical release. Our conversion to open rate is 0.2%. Two-thirds of this statistically small group of conversions were opened due to unsuspected malignancies found at the time of surgery.

Complications fall into two categories. First, complications that arise during surgery may include bleeding, abnormal anatomy, severe scarring and fragile or severely diseased organs. Second, complications may arise after surgery that are related to the specific type of surgical procedure.

Antireflux procedures can have the side effects of:

• Difficulty swallowing
• Impairment of the ability to vomit and rarely burp
• Increased flatus
• A breakdown of the repair - predominantly caused by trauma such as auto accidents, or severe falls
• Continued need for medication

Most of these side effects are not long term. Those patients developing persistent difficulty swallowing post-operatively may occasionally require esophageal dilatation.

* It is very rare that patients report no improvement in their symptoms-less than one half of one percent.*

Inguinal hernia patients will often experience bruising at the base of the penis and/or the scrotum. This transient effect does not limit a quick recovery and athletes routinely return to activity within one week.

Pancreatic resections, drainage of abdominal abscess, and occasionally gallbladder removal can require a drainage tube placement. The narrow tube is placed during surgery to aid in the draining of bile. The tube is easily removed during the postoperative period without further anesthesia or surgery.

In summary, Dr. McKernan of The Center for Videoscopic & Laser Surgery has personally performed over 5,000 laparoscopic procedures. This number does not include procedures in which Dr. McKernan was teaching or assisting another surgeon. These surgical outcome statistics have also been documented in numerous medical publications.