[The place of laparoscopy in gynecological practice--useful technique for diagnostic and treatment of infertility and endometriosis]

OBJECTIVE: The objective was to evaluate indications for laparoscopy performed in Department of Gynecological Surgery of Polish Mother's Memorial Research Institute. MATERIALS AND METHODS: We have analyzed hospital charts of 342 patients who had been treated with laparoscopy in 1991-1999. RESULTS: During last years a progressive frequency in performing laparoscopic procedures has been noted (4.7% of all surgical treatment in 1991-93, 6.4% in 1994-96, 16.3% in 1997-99, and 25.2% in 1999). An increased percentage of operative laparoscopic procedures has also been observed (11.9% in 1991-93 vs 59.8% in 1994-96 vs 86.9% in 1997-99). The major indication for performing laparoscopy was: infertility (145--42.4%), endometriosis (90--26.4%) and benign ovarian tumors. Most of laparoscopic operations were performed due to benign pathological changes found in adnexa (218--68.6%). Laparoscopy has been recently introduced in surgical treatment of uterine myoma (enucleation, laparoscopically assisted vaginal hysterectomy-LAVH) and diagnosis of ovarian carcinoma. Complications were found in 19 (5.5%) cases: 11 cases (3.2%) intraoperative and 8 (2.3%) cases postoperative. Bleeding from abdominal wall vessels was the most often intraoperative complications, whereas an infection was the most common postoperative one. Because of complications laparoscopy turned into laparotomy in four cases. CONCLUSION: Laparoscopy is a safe and useful technique for treatment some gynecological pathology (especially infertility and endometriosis) with a small number of complications.