Clinical Application of Diagnostic Laparoscopy in Gynecology

Laparoscopy is simple, and safe procedure to evaluate clinical diagnosis under direct vision, to avoid unnecessary operation and used to assess the pelvic abnormalities and infertility. One hundreds and eighteen cases who underwent diagnostic laparosocopy from January, 1980 to December, 1986 were analyzed clinically. The results of the study are as follows; 1) Clinical indications for diagnostic laparoscopy were suspicious ectopic pregnancy(44.9%), infertility(23.8%), obscure pelvic mass(11.9%), amenorrhea(10.2%) and pelvic pain(4.2%). 2) The acurracy of clinical diagnosis confirmed by laparoscopy was 72.0%. 3) Abnormal laparoscopic findings were demonstrated in 82.2% of 28 infertility cases which included 2.5%(7cases) of unilateral tubal obstruction, 14.3%(4 cases) of unilateral hydrosalpinx, 17.8%(5 cases) of polycystic ovaries and other abnormal finding cases. Agreement between hysterosalpingography and laparoscopic finding were observed in 54% of the cases. 4) In 75.5% of clinically suspicious ectopic pregnancy cases, ectopic pregnancy was confirmed by laparoscopy, and other cases were found to be ruptured corpus luteum(11.3%), normal pelvic organ(5.6%), regurgitation of menstrual blood(3.8%), torsion of ovarian cyst(1.9%) and pyosalpinx(1.9%). 13.2% of the suspicious ectopic pregnancy cases could avoid unnecessary operation with the use of laparoscope. 5) Identical ciagnoses on clinical impression and laparoscopy were found in 63.6% of ovarian cyst cases, 100% of myoma uteri, pelvic abscess, and endometriosis cases, respectively, 50% of pelvic inflammatory disease cases, and 33.3% o uterine perforation cases. One case of ectopic pregnancy was found during the laparoscopic sterilization. 6) Laparoscopic evaluation of 8 cases of primary amenorrhea showed 50% (4 cases) of no ovaries or streak ovaries, 25%(2 cases) of Mullerian dysgenesis, 12.5%(1 case) of male hermaphroditism, and 12.5%(1case) of ovarian tumor. Polycystic ovaries were found in 50%(2 cases) of 4 secondary amenorrhea cases and other cases showed absence of one ovary and normal pelvic organ.