Principles of laparoscopic reproductive surgery
Epublication WebSurg.com, Mar 2012;12(03). URL: http://websurg.com/doi/lt03enadamson002
Professor Adamson exposes the rules for laparoscopic reproductive surgery. Laparoscopy is first part of the diagnosis, such as ultrasonography or hysterosalpingography. Preoperative principles rely on the informed and signed consent of the patient. Professor Adamson then covers intraoperative rules such as the importance of a good vizualisation (i.e., exposure), control of the surgical field, and proper use of energy sources. Prevention of adhesions is essential because the rate of adhesion is lower with laparoscopy than with laparotomy; it is however quite high (65-88%). A microsurgical technique associated with anti-adhesion barriers seems to be effective. At the end of laparoscopic surgery, the surgeon must give the patient a prognosis for fertility: the Endometriosis Fertility Index seems to be a very useful tool.