Zero Complications in 2675 Laparoscopic Gynecological Operations – Reasons for Success

Open Access

Abstract

Background: Laparoscopic gynecological surgery, while minimally invasive, carries inherent risks of complications. Achieving a zero-complication rate in a large series is a significant benchmark for surgical safety and quality, yet it is rarely reported in the literature. Objective: To analyze the factors contributing to the absence of major complications in a large, multicenter cohort of patients undergoing laparoscopic gynecological procedures. Methods & Materials: A retrospective, multicenter study was conducted from January 2012 to June 2025 at Comilla Trauma Centre, two CMHs, and two other hospitals in Bangladesh. Data from 2,675 consecutive patients were analyzed using MS Office tools. The study cohort comprised women of reproductive age presenting with infertility, pelvic pain, or abnormal bleeding. All patients were managed under a strict, standardized protocol from preoperative assessment through postoperative follow-up. Results: Analysis of 2,675 procedures demonstrated a 0.0% major complication rate. The cohort (mean age 32.4 ±6.1 years) most frequently presented with infertility (58.5%) and chronic pelvic pain (25.2%). Procedures were efficient, with a mean operative time of 42.5 ± 18.3 minutes and a mean blood loss of 35.2 ± 22.1 mL, resulting in a 98.1% discharge rate within 24 hours. The surgical distribution was led by Diagnostic Laparoscopy (64.0%), followed by Ovarian Cystectomy (15.8%) and Endometriosis Surgery (12.2%); complex hysterectomies collectively constituted 1.1%. Conclusion: The zero-complication rate underscores the success of a holistic protocol integrating stringent preoperative assessment, meticulous operative technique with advanced instrumentation, judicious antibiotic use, and systematic postoperative follow-up, ensuring patient safety at every stage