Port-Site Complications Following Laparoscopic Gynaecological Surgery: An experience from a Camp-Based Surgical Setting

Abstract

Background: Gynaecological laparoscopy has become the standard of care for a wide range of benign and malignant conditions. Despite its advantages, port site complications remain a source of morbidity and concern for both patients and surgeons. Aim: To determine the morbidity associated with port-entry complications during gynaecological laparoscopy. Materials and Methods: This study included 739 patients undergoing laparoscopic procedures for various gynaecological indications between May 2013 and January 2020. Demographic data, surgical details, and postoperative outcomes were recorded. Port site complications were classified according to CDC and NNIS definitions. Microbiological evaluation (Gram stain, AFB stain, GeneXpert, culture sensitivity, biopsy) was performed when indicated. Statistical analysis was conducted using SPSS v15.0. Results: Of 739 laparoscopic procedures, 18 patients (2.44%) developed port site complications. The most frequent complication was port site infection (n=13; 1.76%), of which 9 were due to atypical mycobacteria (Mycobacterium fortuitum, M. chelonae). Other complications included abdominal wall vessel injury (n=2), ecchymosis (n=2), and omental entrapment (n=1). Port site complications showed a statistically significant association with the type of laparoscopic procedure performed (p = 0.004), indicating that the occurrence of complications varied meaningfully across different surgical categories. Port site infections were most common at the left lower secondary port. All aerobic infections responded to sensitive oral antibiotics, while atypical mycobacterial infections required prolonged second‑line antimicrobial therapy and surgical exploration in selected cases. Conclusion: Port site complications in gynaecological laparoscopy are infrequent but can be clinically significant. Port site infections, particularly those caused by atypical mycobacteria, are the most agonising for patients and surgeons. Strict adherence to aseptic protocols, meticulous sterilisation of reusable instruments, and early recognition with appropriate antimicrobial therapy are essential to minimise morbidity.