[Pelviscopic surgery in gynaecology (author's transl)]

Abstract

Surgery of the fallopian tubes has today developed into pelviscopic surgery. The development of suitable instruments such as the tube set, a new endocoagulation method were prerequisites for this development. Operative therapeutic pelviscopic surgery is a development past laparotomy. It is now possible to treat adhesions in the abdomen with this method, to coagulate and divide fallopian tubes for sterilization, to aspirate ovarian cysts and resect walls of ovarian cysts, to coagulate endometriosis and to perform salpingolysis and salpingostomy. In selected cases ovariectomy and myomectomy are possible through the pelviscope. Tables and statistics on 3300 pelviscopies are presented. The indications are discussed. The use of pelviscopy following previous laparotomy (1831 cases) is discussed. The complication rate was 1.10% without death, without injury to large vessels, without embolic phenomenon. The operative risk is therefore less than that of laparotomy. The operative therapeutic pelviscopy can replace the classical laparotomy in about 25% of the cases. For the operation of tubal infertility, a laparotomy is eliminated in about 80% of the cases.

PIP: Pelviscopic surgery was performed on 3300 patients for disorders that previously required laparotomy, a more complex operative procedure. In the majority of the cases, operations to correct sterility involving Fallopian tube disorders, e.g. salpingolysis, fimbrioplasty, salpingostomy, can be corrected at the same time the diagnostic procedure is performed. No pregnancies have been reported among 562 pelviscopic tubal sterilizations. Adhesions were treated successfully in 267 cases with pelviscopic surgery. A pelviscopic procedure is preferred for ovarial biopsy and the point biopsy of benign ovarial cysts. Special equipment and techniques have been developed for pelviscopic ovariectomy and myomectomy in certain cases. The complication rate for 3300 pelviscopic operations was 1.1%, comparable to that of laparotomy. In 1211 cases the operation was done for diagnostic purposes, in 1895 cases for operative-therapeutic purposes, and in 194 cases diagnosis and operation were performed simultaneously. In 49.6% of the cases, the pelviscopic operation reduced the hospitalization period, compared to laparotomy. In 1831 cases, pelviscopy was performed after a previou laparotomy. Pelviscopic procedures can be performed instead of laparotomy in 25% of the cases and 80% of the operations to correct sterility caused by Fallopian tube disorders.