Systematic review of iatrogenic lesions during endoscopic procedures and medico-legal implications

Background: Endoscopic procedures, while minimally invasive and generally safe, carry inherent risks, including the potential for iatrogenic lesions that can lead to significant complications and, in some cases, medico-legal implications. This narrative review with a forensic focus aims to evaluate the incidence, types, and medico-legal considerations of iatrogenic lesions resulting from endoscopic proce-dures, with an analysis of selected case studies to underscore clinical and forensic aspects. Methods: We assessed data from peer-reviewed publications focusing on complications associated with endoscopic procedures and other adverse outcomes, following a PRISMA-guided search for transparency. Results: Findings indicate that factors such as procedural complexity, patient comorbidities, and operator experience significantly influence the risk of iatrogenic injury. From a medico-legal perspective, delayed recognition or inadequate management of such lesions can lead to patient harm and subsequent legal actions. This review highlights the importance of meticulous technique, thorough informed consent, and prompt post-procedural assessment to mitigate these risks. Conclusions: By synthesizing insights from clinical cases with forensic analyses, this study underscores the need for enhanced procedural guidelines, improved training, and proactive risk management to minimize both patient harm and medico-legal repercussions associated with endoscopic procedures.