[Development of gynecologic endoscopy in Germany--a statistical overview 1989 to 1993]

The first statistical report on pelvioscopy/laparoscopy of total Germany covers a five years period from 1989, 01.01 to 1993 31.12. It includes a total of 461,568 pelvioscopies/laparoscopies from 374 hospitals and 52,861 pelvioscopies/laparoscopies from 116 medical practitioners. Hospitals' response rate was 43% with 99.2% reporting pelvioscopy/laparoscopy. The response rate of medical practitioners was 41% with 97.4% performing same methods. During the five year period of survey, hospitals reported a total of 2095 serious complications requiring laparotomy or control laparoscopy (complication rate = 4.5/1000). Medical practitioners reported a total of 197 serious complications (complication rate = 3.7/1000). Compared with the data of the fourth statistical survey of laparoscopy (1986 to 1988) there is a remarkable increase in serious complications. Most of them are mechanical lesions of blood vessels in the abdominal wall or in the mesosalpinx, followed by mechanical lesions of the intestine. Also remarkable is the observation that pelvioscopy/laparoscopy as surgical method is continuously increasing. As shown in previous statistics on pelvioscopy for tubal sterilization the bipolar technique is the most popular one for both hospitals and medical practitioners. It is followed by endocoagulation after Semm whereas mechanical techniques are of little importance. The monopolar high frequency current is still used in 9.6% by hospitals and 8.8% by medical practitioners, with and without transsection. Sterilization failure rate remains nearly at the same levels as it was reported previously: 1.6/1000 in hospitals and 3.7/1000 in private practices. The highest failure rate was observed after the use of monopolar HF-techniques. 82.5% of the hospitals and 65% of the medical practitioners reported tendency in performing endoscopy by surgery is continuously increasing.