[Endoscopic intraabdominal surgery in gynecology]

Modern technique leads to abdominal surgery under "miniature" conditions. The combination of electrically monitored pneumaperitoneum, cold light optic, new mini-instruments, the newly developed hemostatic procedure "endocoagulation" (the patient is not in contact with the electrical current) and intraabdominal ligation techniques allows a new spectrum of operative procedures to be performed in gynecology. The following endoscopic gynecological operations have become routine: adhesions, ovario- and fimbriolysis, sharp and blunt opening of the ampulla tubae (sterility-operations), enucleation of pedunculated subserous myomas, conservative and radical tubal therapy of ectopic pregnancy, ovarian biopsy, ovarian cyst enucleation, ovarectomy ("3-sling-technique"), coagulation of endometriosis, tubal ligation. As examples of non typical gynecological operations in general surgery, omental adhaesiolysis, lysis of bowel adhesions and appendectomy can be mentioned. These new operative techniques have been developed in more than 10,000 pelviscopies. They stand for laparotomy in up to 80% of all cases in tubal and ovarian surgery. The complication rate lies in the area of 2%. Hospitalization has diminished by more than 50%, the period of reconvalescence by more than 75%.