Relation between difficulty level of laparoscopic procedures and the incidence of complications during urologic laparoscopic surgery in Dr. Sardjito Hospital

Background: Laparoscopy is a minimally invasive procedure in which a camera and a light source are inserted into the abdomen, whereas the postoperative incision appears to be smaller than the conventional surgery incisions. In the field of urologic surgery, this method of surgical approach causes a few complications. Method: This research is a retrospective design using secondary data from medical records in Dr. Sardjito Hospital through a timeframe of January 2017 to January 2020. Included in this study were 82 cases of laparoscopic surgery patients. Study results were presented descriptively and analytically. Results: The incidence significantly increased with the increased difficulty level (p< 0.05). Statistically were the highest morbidities found in radical cystectomies, around 55%, if compared to other procedures (p<0.05). Types of complications found were vascular injuries (4 cases) and organ injuries (5 cases). Five laparoscopic procedures (6.1%) had to be converted to open procedures. There were no significant differences between the three groups according to conversion to open procedures (p > 0.05). Conclusion: The difficulty level of the procedures was correlated to the intraoperative complications. The higher the difficulty level of the urology laparoscopic procedures, the higher the incidence of complications. To decrease the incidence of complications, there have to be regularly scheduled standardized courses, to increase the knowledge in laparoscopic procedures, anatomical knowledge, and exposure to the different procedures.