LAPAROSCOPY

Laproscopic sterilization techniques and the diagnostic use of laparoscopy are discussed. In a series of 1000 laparoscopic sterilizations by the 2-incision technique, there was a total failure rate, surgical and operative, of .4%. In a similar series with the 1-incision technique and electrocagulation only, the total failure rate was 1.6%, though the complication rate was considerably reduced. The high failure rate was attributed to incomplete transection resulting in recanalization. The failure rate with a single-incision, 3-burn technique was .25% in a series of 2000 patients, and complications were few. Tubal occlusion with hemoclips has produced poor results (failure rate: 8-27%). The results with silastic bands, however, have been comparable to those for electrocoagulation, but with fewer complications. Means by which the cost of laparoscopic equipment may be reduced are discussed. Laparoscopy can be helpful in the diagnosis of infertility-endocrinology, ectopic pregnancy, pelvic pain, pelvic inflammatory disease, adnexal masses, and the retrieval of foreign bodies in the pelvic region. Contraindications to laparoscopy are reviewed. It is concluded that laparoscopy is a safe and effective means of sterilization on an outpatient basis, and is of value in the diagnosis of gynecologic disorders.