Avoiding and managing complications during gynaecological surgery

Even with conscientious preparation and appropriate care by experienced surgeons, unexpected difficulties may be encountered leading to damage to adjacent structures with potentially serious consequences. With the increasing use of endoscopic surgery, experience with safe techniques and potential pitfalls with this surgery is as essential as for ‘conventional’ gynaecological surgery. The recognition of unexpected trauma at the time of surgery is important as is knowledge of appropriate repair procedures; correction of surgical damage at the time is usually preferable to interval surgery. All surgeons should know their limitations and readily seek advice and help from others, either their seniors within the speciality or those in another surgical speciality. Patients should be advised pre-operatively of well-recognized complications associated with the operation they are having and appraised after the operation of any complications sustained, what treatment was given and any likely long-term implications.