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pubmed:abstractText |
In order to avoid the misuse of laparoscopy by an unnecessary increase in the indications for the procedure the authors have reviewed the evolution of these indications in the five years between 1973 and 1977. Certain indications have stayed stable, such as chronic pain in the pelvis, masses found in the pelvis, symptoms suggestive of upper genital tract infection or of ectopic pregnancy and tubal or unexplained sterility. Stability in these indications is correct because laparoscopy and laparoscopy alone can give a precise diagnosis of the lesion and complete the clinical findings and the other methods of investigation. There are two indications which have become less frequent and these are: ovarian sterility and amenorrhoea. This is logical since more reliance has come to be placed on biological methods. Laparoscopy should be reserved in these conditions for cases where are contradictions between biological findings or where there are therapeutic failures. An increase in the indications which is very justified is in those laparoscopies which are carried out as a control of the results of tubal surgery, because there a prognosis can be given and therapy can be carried out (such as division of adhesions) and in cases of malignant tumours of the ovary which, although the procedure will give less precise information than laparotomy, has the advantage that it can be repeated from time to time.
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