Syeda Batool Mazher, Rehana Kama.
Operative Laparoscopy for benign gynecological problems: a three year study.
Ann Pak Inst Med Sci Jan ;1(2):96-100.

Objectives: To evaluate usefulness of operative laparoscopy in management of Benign gynecological problems. Study Design: A retrospective study. Setting: Department of Gynecology & Obstetrics, Unit II, MCH Centre, PIMS, Islamabad. Duration: May 2001 to April 2004. Methods: The study was carried out at MCH Centre, PIMS, Islamabad, where all patients undergoing operative laparoscopy for various gynecological problems were included. Patients having contraindications to general anesthesia or who were hemodynamically unstable or had had undergone previous 2 or more major abdominal surgeries were excluded. Main out come measures were surgical time, per operative and postoperative complications and length of hospitalization. Results: Total number of gynecological surgeries perform during the study period were 506. Of these 167 were diagnostic laparoscopies while operative laparoscopies were 70 in number. Mean age of the patients was 29 years. The commonest indication for operative laparoscopy was Infertility (42.9%). Other indications were Adnexal mass (18.6%), chronic pelvic pain (12.9%), Ectopic pregnancy ((12.9%), Laparoscopic BTL (5.7%), lost IUCD ((4.3%) and Acute abdomen (2.9%). The procedures performed included Cystectomy (31), ovarian drilling (13), removal of Ectopic pregnancy (9), Adhesiolysis (6), Tubal ligation (5), and Retrieval of lost IUCD (4). Depending on the type of procedure the operative time ranged between 29 to 75 minutes. Laparoscopy was converted to, laparotomy in 9 patients. The commonest reason of conversion (6 cases out of 9) was intractable heamorrhage. 6 women had post operative pyrexia, one had chest congestion and one developed urinary retention. Rest of the patients (90%) had uneventful postoperative recovery. The mean hospital stay after laparoscopy was 2 days. Conclusion: Operative laparoscopy is a minimally invasive procedure that carries low morbidity, shorter hospital stay & faster return to normal activity. It is preferred cosmetically.

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