Development of flexible culdoscopy

STUDY OBJECTIVE: To assess correlation between findings at standard laparoscopy and office flexible culdoscopy. DESIGN: Observational study (Canadian Task Force classification II-1). SETTING: University-affiliated hospital. PATIENTS: Eleven women undergoing diagnostic laparoscopy to evaluate infertility. INTERVENTIONS: Microlaparoscopy and flexible culdoscopy. In the first six cases laparoscopy was performed first followed by culdoscopy; in the last five cases the order was reversed. MEASUREMENTS AND MAIN RESULTS: The number of endometriotic implants or adhesions was counted for both operative techniques. The flexible 2.2-mm culdoscope provided a view of the pelvis similar to the laparoscope. Correlation between the procedures was 100%. The flexible scope achieved better visualization than the standard rigid posterior cul-de-sac culdoscope. CONCLUSION: Flexible culdoscopy is a excellent procedure for diagnostic endoscopy. It correlates well with office laparoscopy, requires less anesthesia, and is better tolerated by patients. Several operative procedures are currently being tested through this mode of access.