Endocoagulation: a new filed of endoscopic surgery

Abstract

Pelviscopy was predominantly concerned with diagnostic procedures until recent years. Modern electronically controlled coagulation instruments, such as the crocodile forceps and the point coagulator, permit the application of destructive heat without any risk of electric current within the abdominal cavity. The electronically regulated apparatus for these coagulation instruments is the Endo-Coagulator, which indicates the coagulation temperature optically and acoustically. The endocoagulation technique opens a new area of operative gynecology. In the field of sterility operations, adhesion cuttings and the treatment of endometriotic and juvenile ovarian cysts, the application of modern endocoagulation has reduced the frequency of laparotomy by about 30% to 40%.

PIP: The successful use of the Endo-Coagulator, an electronically regulated apparatus for pelviscopy and coagulation of tubes, adhesions or, bleeding areas after ovarian biopsy is reported. The need for laparotomy has been reduced by about 30-40%. The instrument provides automation for the production of pneumoperitoneum by carbon dioxide. The lower pelvis is illuminated with cold light without danger of burning. The uterus can be mobilized with an intrauterine vacuum sound. These instruments have the advantage that the electric current does not touch the patient but heats a resistant wire. The heating temperature can be preselected. Tissue can be coagulated at the temperature of boiling water. A sound device signals an increase in temperature and indicates cooling of the forceps which can then be used as a palpation rod. The whole coagulation time can be set by the surgeon. The tubes may be sectioned with the hook scissors but this is not always done. Peritoneal adhesions can be separated and a sactosalpinx opened bloodlessly. After pelviscopic salpingolysis the lower pelvis is cleansed with saline solution and 500 mg of cortisol preparation introduced. Prolonged hydroperitubation follows for 5 or 6 days. The cervix adapter remains 6-8 hours to hinder outflow of the instilled solution. More than 500 sterilizations have been done successfully with no subsequent pregnancies. Over 250 ovarian cyst wall resections have been performed with no recurrences.