Experience with diagnostic laparoscopy for gynecological indications

Abstract

Context: Diagnostic laparoscopy is an endoscopy procedure, which has become indispensable in the evaluation of the female reproductive organs especially in infertility.
Aim: Experience with conversion to open laparotomy is presented and ways of averting this complication are discussed.
Settings and Design: A retrospective study was performed.
Materials and Methods: All the 1654 diagnostic laparoscopies performed at a private fertility center over a 10.year period (January 2000 to December 2009) were analyzed for indications, cases of conversion to open laparotomy, and measures taken to prevent this complication.
Statistical Analysis Used: Simple percentage method was used.
Results: Infertility was the commonest indication for 1627 (98.4%) procedures, while primary amenorrhoea and chronic pelvic pain were responsible for 20 (1.2%) and 7 (0.4%) procedures, respectively. There was no mortality in this series. There was conversion to open laparotomy due to hemorrhage in only 2 (0.12%) procedures and this happened at the
first year of practice.
Conclusions: The low rate of conversion was attributed to the surgeons experience, proper patient selection, and the use of Palmers point for insufflation in some patients with previous pelvic surgeries and use of supraumbilical access in patients with pelvic masses. Diagnostic  laparoscopy for gynecological indications is safe and wider application of
this modern technology is recommended for our practice.

Key words: Amenorrhoea, conversion, hemorrhage, infertility, laparoscopy