Complications - Supracervical hysterectomy, bilateral salpingectomy, robot-assisted laparoscopy (DaVinci)

Bleeding:

• Blood loss > 1000 ml in 1–3% of cases
• Injury to the iliac artery or uterine arteries
• Pelvic hematomas due to inadequate hemostasis

Injuries to adjacent organs:

• Bladder injury (0.59–1.0%), increased with prior surgeries (e.g., C-section)
• Ureteral injury (0.09–0.3%), often recognized postoperatively
• Bowel injury (0.2–0.4%), more common with adhesions or endometriosis

CO₂ insufflation complications:

• Subcutaneous emphysema or gas embolism
• Pneumothorax or mediastinal emphysema with excessive insufflation pressure

Nerve injuries:

• Lesion of the obturator nerve or sacral plexus
• Postoperative neuropathic pain

Technical complications:

• Conversion to laparotomy (2–4%), e.g., in cases of massive adhesions
• Inadequate coagulation or hemostasis

Bleeding & Hematomas:

• Postoperative bleeding (0.94–1.8%)
• Pelvic hematoma or abdominal hematoma

Urinary tract complications:

• Urinary retention (0.5–1.6%) due to bladder neck edema
• Urinary tract infections (0.7–2.2%) due to catheterization
• Fistula formation with unrecognized bladder or ureter injury

Bowel dysfunction:

• Postoperative ileus (0.09–1.0%), especially with adhesions
• Constipation due to altered pelvic floor statics

Infections:

• Wound infection (0.9–2.4%) at trocar sites
• Pelvic infection, hematoma, or abscess (1.0–5.4%)
• Sepsis (0.03%)

Thromboembolic events:

• Deep vein thrombosis or pulmonary embolism (0.02–0.03%)

Vaginal complications:

• Dyspareunia due to scar formation