1000 consecutive laparoscopies in gynaecological practice

One thousand consecutive laparoscopies were performed by an individual team at University College Hospital, Galway from 1982 to 1990. The mean age of the patients was 34 years (range 15-61). The majority (702) were undertaken for tubal ligation, followed by investigation of infertility (125), pelvic pain (87) and suspected ectopic pregnancy (41). Laparotomies were avoided in 77 patients with pelvic pain and in 26 patients with suspected ectopic pregnancy. A further 73 patients had surgical procedures performed laparoscopically. There were no failed laparoscopies. Minor complications occurred in 1.3% of patients. The commonest difficulty encountered was failed first attempt at pneumoperitoneum (4%). Two patients required laparotomy following laparoscopy, because of intra-abdominal bleeding. Readmissions occurred in 7 patients but again no serious sequelae were recorded. The use of the laparoscope in general gynaecological practice is examined with the safety, diagnostic and therapeutic facilities of the procedure explored.