[Pelviscopic ovarian surgery. Possibilities and limitations]

In analyzing 500 consecutive pelviscopies performed at the University Women's Clinic in Kiel in 1988, 310 patients had undergone either diagnostic or operative procedures on the ovary, i.e. pelviscopy in the case of an ovarian tumor. 95.5% of all procedures could be performed per pelviscopy. 4.5% of cases required therapy per laparotomy. The pelviscopic procedures were primarily organ preserving operations associated with minimally invasive surgery, for example: Ovariolysis, ovarian cyst enucleation, coagulation of ovarian endometriotic implants, follicle puncture, parovarian cyst enucleation and, salpingo-oophorectomy. Laparotomy was indicated in the case of malignant disease, borderline tumors, large tumors, extensive adhesiolysis status post previous laparotomy, and in one case uncontrollable bleeding. The results show that today most procedures on the ovary can be performed per pelviscopy. In order to prevent a pelviscopic intervention in suspicious cases, the indication for laparotomy here must be generously applied.