Pelvic laparoscopy at the Mount Sinai Hospital: A report of 384 consecutive cases at the Mount Sinai Medical Center, 1973-1974.

Laparoscopy was performed on 384 patients for diagnosis (96) or sterilization (193). All were inpatient procedures under general endotracheal anesthesia with assisted ventilation using the double puncture technique. Contraindications to laparoscopy were: 1) previous extensive surgery 2) hernias 3) intolerance to anesthesia 4) chronic medical disease 5) generalized peritonitis and 6) marked obesity. Indications were: 1) bilateral tubal fulguration 2) infertility 3) localization and removal of translocated IUDs and 4) evaluation of pain or mass. In 48 patients no abnormalities were found. Positive and differential findings included asmexitis (49) ovarian cysts (21) endometriosis (19) unruptured ectopics (13) fibroids (9) cancer of the cecum (1) and 3 ruptured ectopics. Hemmorhage was the most common complication followed by bowel injury uterine perforation wound infection electrical burn of the abdominal wall and pregnancy following tubal fulguration. A total of 25 patients were affected of which the greatest number (15) were affected by bleeding in the mesosalpinx infundibulo-pelvic ligament and broad ligament. There were 11 cases of unsuccessful laparoscopies because of carbon dioxide leaks poor visualization and inability to enter the peritoneal cavity. This technique has replaced culdoscopy because of the advantage of rapid recovery shorter hospital stay and savings to the patient and hospital.