Endoscopic surgery in a gynecologic outpatient clinic

Abstract

From 1988 to 1989, we operated on 784 women in our daily ambulant clinic. In 462 of these cases, we performed laparoscopic surgery with 679 therapeutical interventions. Sterilisation is the most frequent operation in our cases of Fallopian tube surgery, but we have also had tubal pregnancy in 5 cases. In ovarian surgery, we found a great number of benign ovarian cysts followed by a high rate of ovarian adhesions, which, counted together with the Fallopian tube and intestinal adhesions, amounted to 201 cases. In 9 women, the extirpation of a myoma was necessary and the largest one was 5.5 cm in diameter. In comparison with the total number of our surgical interventions, we had a high rate of appendectomies. Each surgeon is aware of the various locations of the appendix, of its close relation to the adnexae and the difficulty of clinical diagnosis of appendicitis in women, especially in pregnant women. We removed the appendix in two pregnant women (4th and 18th week of pregnancy). A pathological substrate was found in more than 80%. Because of a good preliminary selection of our patients, we found no carcinoma in the abdominal cavity, except from an early metastasis on the appendix of an ovarian carcinoma. This patient came for staging re-laparoscopy after treatment of the ovarian carcinoma years ago. Since the beginning of 1989, we have used a Neodym: Yag laser in endoscopic operations. The good cutting effect loses its benefits of precision and time saving through bleeding as soon as a large vessel is involved.(ABSTRACT TRUNCATED AT 250 WORDS)