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A Retrospective Audit of Gynaecological Laparoscopy performed at Groote Schuur Hospital from July 2015 to June 2017

INTRODUCTION: The development and refinement of laparoscopic procedures has resulted in a paradigm shift in the management of surgical conditions. MATERIALS AND METHODS: This study was a retrospective folder review of women who had an elective gynaecological laparoscopy between 1 July 2015 and...

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Main Author: Bagratee, Sharvay
Other Authors: Van Der Spuy, Zephne
Format: Thesis
Language:English
English
Published: Department of Obstetrics and Gynaecology 2026
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access_status_str Open Access
author Bagratee, Sharvay
author2 Van Der Spuy, Zephne
author_browse Bagratee, Sharvay
Van Der Spuy, Zephne
author_facet Van Der Spuy, Zephne
Bagratee, Sharvay
author_sort Bagratee, Sharvay
collection Thesis
description INTRODUCTION: The development and refinement of laparoscopic procedures has resulted in a paradigm shift in the management of surgical conditions. MATERIALS AND METHODS: This study was a retrospective folder review of women who had an elective gynaecological laparoscopy between 1 July 2015 and 30 June 2017. Patients were identified from theatre records. Folders were retrieved and data were collected using a template. The data were double entered and then compared to eliminate capture error. Statistical analysis was performed with STATA Statistics. Inclusion criteria were all elective gynaecological laparoscopies during the stipulated period. RESULTS: A total of 355 patients were identified from theatre records, 49 patients were excluded (6 laparotomies, 30 emergencies, 13 folders absent or missing notes). Finally, 306 patients were included in the study. The age range was 17 to 80 years. BMI was recorded for 148 patients (48,3%) of whom 42 (28,4%) were overweight and 62 (41,9%) were obese. Medical comorbidities were reported in 113 (37%) patients, mainly hypertension and diabetes (combined 26%). At least one previous abdominal surgical procedure was recorded for 132 patients (43,1%). Of these, 104 patients (33,4%) had a previous laparoscopy and 58 patients (19%) had a previous laparoscopy for the same indication or diagnosis. The most reported symptoms were pain (n=138; 45,1%), infertility (n=84; 27,5%) and abnormal uterine bleeding 8 (n=82; 26,8%). The common diagnoses were infertility (n=82; 26,8%), chronic pelvic pain (n=72; 23,5%), adnexal mass (n=47; 15,4%) and endometriosis (n=42; 13,8%). The Reproductive Medicine Unit performed 169 (55,2%) of the surgeries. A specialist or subspecialist trainee was the primary surgeon in 258 cases (84,3%). The procedures most performed were diagnostic laparoscopy (n=86; 28,1%), salpingectomy (n=55; 18%), total laparoscopic hysterectomy (n=50; 16,3%), cystectomy (n=40; 13,1%) and excision of endometriosis (n=29; 9,5%). Adhesiolysis was an unexpected additional procedure in 108 (35,3%) surgeries. The average procedure duration was 117 minutes (SD 65,4 minutes). The average blood loss, where numerically recorded, was 160,4ml (SD 176,6ml). The complication rates, both intra-operative (n=25; 8,2%) and post-operative (n=24; 7,8%), were comparable to international rates. There was no mortality secondary to surgery. Intra-operative conversion to laparotomy was required in 11 (3,6%) patients. Nine women had visceral injury. Sepsis was the most common post-operative complication (n=9; 2.94%), either systemic or at the local port-site. Three patients required relook laparotomies (0,98%). Follow up data were available for 226 (73,9%) patients of whom 151 (66%) reported resolution of symptoms and satisfaction with the surgery. CONCLUSION: Laparoscopy has become an increasingly utilized surgical approach in gynaecology. The gynaecology units at GSH perform appropriate, safe, and at times complex laparoscopic procedures with good outcomes and low complication rates. Emphasis must be placed on the development of laparoscopic skills in all specialist trainees.
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provenance_str_mv Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository
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spelling oai:open.uct.ac.za:11427/43334 A Retrospective Audit of Gynaecological Laparoscopy performed at Groote Schuur Hospital from July 2015 to June 2017 Bagratee, Sharvay Van Der Spuy, Zephne Gynecology Gynecological Laparoscopy Endometriosis INTRODUCTION: The development and refinement of laparoscopic procedures has resulted in a paradigm shift in the management of surgical conditions. MATERIALS AND METHODS: This study was a retrospective folder review of women who had an elective gynaecological laparoscopy between 1 July 2015 and 30 June 2017. Patients were identified from theatre records. Folders were retrieved and data were collected using a template. The data were double entered and then compared to eliminate capture error. Statistical analysis was performed with STATA Statistics. Inclusion criteria were all elective gynaecological laparoscopies during the stipulated period. RESULTS: A total of 355 patients were identified from theatre records, 49 patients were excluded (6 laparotomies, 30 emergencies, 13 folders absent or missing notes). Finally, 306 patients were included in the study. The age range was 17 to 80 years. BMI was recorded for 148 patients (48,3%) of whom 42 (28,4%) were overweight and 62 (41,9%) were obese. Medical comorbidities were reported in 113 (37%) patients, mainly hypertension and diabetes (combined 26%). At least one previous abdominal surgical procedure was recorded for 132 patients (43,1%). Of these, 104 patients (33,4%) had a previous laparoscopy and 58 patients (19%) had a previous laparoscopy for the same indication or diagnosis. The most reported symptoms were pain (n=138; 45,1%), infertility (n=84; 27,5%) and abnormal uterine bleeding 8 (n=82; 26,8%). The common diagnoses were infertility (n=82; 26,8%), chronic pelvic pain (n=72; 23,5%), adnexal mass (n=47; 15,4%) and endometriosis (n=42; 13,8%). The Reproductive Medicine Unit performed 169 (55,2%) of the surgeries. A specialist or subspecialist trainee was the primary surgeon in 258 cases (84,3%). The procedures most performed were diagnostic laparoscopy (n=86; 28,1%), salpingectomy (n=55; 18%), total laparoscopic hysterectomy (n=50; 16,3%), cystectomy (n=40; 13,1%) and excision of endometriosis (n=29; 9,5%). Adhesiolysis was an unexpected additional procedure in 108 (35,3%) surgeries. The average procedure duration was 117 minutes (SD 65,4 minutes). The average blood loss, where numerically recorded, was 160,4ml (SD 176,6ml). The complication rates, both intra-operative (n=25; 8,2%) and post-operative (n=24; 7,8%), were comparable to international rates. There was no mortality secondary to surgery. Intra-operative conversion to laparotomy was required in 11 (3,6%) patients. Nine women had visceral injury. Sepsis was the most common post-operative complication (n=9; 2.94%), either systemic or at the local port-site. Three patients required relook laparotomies (0,98%). Follow up data were available for 226 (73,9%) patients of whom 151 (66%) reported resolution of symptoms and satisfaction with the surgery. CONCLUSION: Laparoscopy has become an increasingly utilized surgical approach in gynaecology. The gynaecology units at GSH perform appropriate, safe, and at times complex laparoscopic procedures with good outcomes and low complication rates. Emphasis must be placed on the development of laparoscopic skills in all specialist trainees. 2026-06-19T11:13:11Z 2026-06-19T11:13:11Z 2026 2026-06-19T10:53:26Z Thesis / Dissertation Masters MMed http://hdl.handle.net/11427/43334 en eng application/pdf Department of Obstetrics and Gynaecology Faculty of Health Sciences University of Cape Town
spellingShingle Gynecology
Gynecological Laparoscopy
Endometriosis
Bagratee, Sharvay
A Retrospective Audit of Gynaecological Laparoscopy performed at Groote Schuur Hospital from July 2015 to June 2017
thesis_degree_str Master's
title A Retrospective Audit of Gynaecological Laparoscopy performed at Groote Schuur Hospital from July 2015 to June 2017
title_full A Retrospective Audit of Gynaecological Laparoscopy performed at Groote Schuur Hospital from July 2015 to June 2017
title_fullStr A Retrospective Audit of Gynaecological Laparoscopy performed at Groote Schuur Hospital from July 2015 to June 2017
title_full_unstemmed A Retrospective Audit of Gynaecological Laparoscopy performed at Groote Schuur Hospital from July 2015 to June 2017
title_short A Retrospective Audit of Gynaecological Laparoscopy performed at Groote Schuur Hospital from July 2015 to June 2017
title_sort retrospective audit of gynaecological laparoscopy performed at groote schuur hospital from july 2015 to june 2017
topic Gynecology
Gynecological Laparoscopy
Endometriosis
url http://hdl.handle.net/11427/43334
work_keys_str_mv AT bagrateesharvay aretrospectiveauditofgynaecologicallaparoscopyperformedatgrooteschuurhospitalfromjuly2015tojune2017
AT bagrateesharvay retrospectiveauditofgynaecologicallaparoscopyperformedatgrooteschuurhospitalfromjuly2015tojune2017