What are the possible complications of laparoscopy for the treatment of cryptorchidism?

Updated: Dec 17, 2020
  • Author: Joel M Sumfest, MD; Chief Editor: Edward David Kim, MD, FACS  more...
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Answer

Complications of laparoscopy include the following:

  • Preperitoneal emphysema may develop secondary to poor needle or trocar placement and insufflation.

  • Hypercarbia may occur with pneumoperitoneum. This can be counteracted by increasing minute ventilation and keeping insufflation pressures at less than 12 mm Hg.

  • The puncture of a viscus with the Veress needle is not harmful unless insufflated or dilated by a trocar.

  • The puncture of a major abdominal vessel is a life-threatening complication. The needle or sheath should be left in place for tamponade, and an emergency open laparotomy is performed. (Almost all the above potentially life-threatening vascular and enteric complications can be avoided by using an open technique for access.)

  • Injury to the inferior epigastric vessels may also occur with trocar placement. Hemostasis can be achieved via direct cautery or via suture/clip ligation from the external surface or laparoscopically.

  • Bladder puncture may occur because the bladder is intra-abdominal in younger children. Care must be taken when placing lower abdominal and scrotal trocars. Repair can be achieved laparoscopically or through a small suprapubic incision. A ureteral injury requires stenting.


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