Diagnostic and operative laparoscopy in Alberta 1994-2006

Laparoscopic surgery has become an important procedure in the diagnosis and management of pelvic pathology. Whether or not repeat laparoscopic procedures, sometimes repeated several times, are of real benefit is unclear. This study was designed to quantify the experience of one province during the period 1994-2006 to explore patterns of laparoscopic surgery.

Data were obtained from Alberta Health and Wellness regarding diagnostic and operative laparoscopic procedures for the years 1994-2006. The postal code of each responsible health facility was recorded and information grouped into the current nine health regions. The use of laparoscopy in individual women was analyzed by aggregating data by region on an annual basis and then across the entire period of the study.

During the years 1994-2006, 51,790 diagnostic laparoscopy procedures and 24,896 operative laparoscopic procedures were performed. Repeat operative rates for 24,473 women were limited when annual rates were analyzed (< 2.0%), but became substantial across the period of study, during which time 36% of women had two or more, 12% had three or more, 5% had four or more, and 2% had five or more operative procedures.

Over an extended period of time, there has been a decline in the rate of diagnostic laparoscopy but not of operative laparoscopy, and there has been a substantial rate of repeat operative laparoscopy per individual woman. These data suggest there may be important reasons for the rates of repeat operative laparoscopy that warrant exploration and the development of practice guidelines.