An overview of consumer-driven ambulatory surgery: operative laparoscopy

Laparoscopy is considered one of the first truly consumer-driven medical advances. It is estimated that 30% to 70% of all gynecologic surgery currently performed via laparotomy incision could be completed by using the laparoscope. The emerging trend in recent years is the change from using the laparoscope in gynecology for diagnosis and tubal sterilization to treating ectopic pregnancy and ovarian neoplasm. The 1991 and 1992 Gynecologic and Obstetrical Society's review and recommendations of this surgical specialty reflect a 1.5-fold increase in the number of laparoscopic procedures reported in 1988. Pelvic pain is the most frequent indication for operative laparoscopy. There is a need for further evaluation of laparoscopy, including an evaluation of cost-savings claims and an evaluation of necessary recovery time in comparison with laparotomy. Primary care providers can effectively monitor patients' potential surgical needs and appropriately counsel patients when armed with knowledge of the benefits and risks of operative laparoscopy. This article provides a review of the history, purpose, benefits, risks, and patient surgical outcomes of operative laparoscopy.