The value of peritoneoscopy in gynaecology.

With modern optical systems high-intensity fiber-optic light sources and a safe and easy method of introducing and maintaining pneumoperitoneum peritoneoscopy is a precise safe and acceptable means of diagnosing gynecological and surgical patients and performing sterilization. The pneumoperitoneum needle is inserted through the lower margin of the umbilicus. Carbon dioxide is introduced at 1 liter per minute up to 3-5 liters causing a large gas bubble to collect in the lower abdomen. After a 0.5 cm longitudinal incision is made at the puncture site the telescope is introduced into the bubble and a general survey is made. Photography of the pelvic organs is possible. If sterilization is to be performed a Palmer drill forceps is inserted through the left iliac fossa to grasp coagulate and sever the isthmus of the fallopian tubes. General anesthesia is usual. A breakdown of 500 cases shows peritoneoscopy used mostly for investigation of sterility (46.4%). 66 operations (13.2%) were performed for the purpose of sterilization. The procedure was successfully carried out on the third to fifth postpartum day. Complication incidence for all procedures was 1.6%. Complications may include puncture of a blood vessel or viscus intestinal perforation gas embolism subcutaneous emphysema and burning of a viscus.