Advances in laparoscopic surgery

Abstract

Objectives: To review some of the recent advances in gynecologic laparoscopic surgery. Current reports on the use of laparoscopy for hysterectomy, myomectomy and endometriosis are summarized and the role of laparoscopy in urogynecology, reproductive surgery and gynecologic oncology is examined. Design: Pertinent studies were identified through computer Medline search. Conclusions: In most cases, laparoscopic hysterectomy can replace its laparotomy counterpart. It is associated with shorter hospital stay and shorter recovery time, but the operating time is longer than that of vaginal or abdominal hysterectomy. Laparoscopic myomectomy is an alternative approach in selected cases. Surgical treatment of endometriosis is best done by laparoscopy and excision of the lesions leads to a more complete removal than vaporization or coagulation. Long term results of laparoscopic uterine nerve ablation is discouraging and long term results of laparoscopic urethropexy remain unknown. Laparoscopic ovarian drilling is an alternative treatment for clomiphene resistant anovulatory women with polycystic ovarian syndrome. The role of laparoscopy in the management of gynecologic malignancy remains to be defined.