LAUSR

Post procedural complications warranting surgery presents a diagnostic and management challenge. Despite the established role of laparoscopy in elective settings, emergency laparoscopic approach in complex circumstances has not been established. The Objective of our study was to assess the safety and efficacy of laparoscopic management for post-procedural (surgical and endoscopic) complications. An MDT approach was utilised involving the on-call teams (surgeon, anaesthetist, trainees and radiologists. Anonymous data are collected prospectively for all emergency laparoscopic procedures since 2021 under a single surgeon. The data of all post-procedural complications following surgery or endoscopy were included based upon Clavien-Dindo classification. The primary outcome measured was peri-operative complications, secondary outcomes were open conversion, length of stay, post-op complication & post laparoscopy return to theatre. There were 21 cases over 3 years for management of post-procedure complications (Clavien-dindo IIIB). The total number of emergency cases managed laparoscopically was 146 over 3-year period. These included post endoscopic perforations (03), anastomotic leaks (04), bowel injury (05) and miscellaneous (09). One case required conversion to open following an anastomotic leak. There were no post-surgical unplanned returns to theatre. Laparoscopy can be an invaluable tool to manage the complex myriads of post-procedural complications. It can safely replace open surgery following invasive procedures to provide definitive diagnosis and treatment for post procedure complications, with a significant reduction of morbidity. MDT approach, careful case selection and skilled laparoscopic surgery in experienced hands can help minimise the stress response to surgery especially in surgical and endoscopic complications.