[Ambulatory laparoscopy].

Abstract

Based on experience with 3100 tubal sterilizations and other pelviscopic operations the following conclusions are drawn: 1. Most endoscopic gynecologic operations can be performed as outpatient procedures by experienced gynecological surgeons without increased risk for patients. But not in all cases these operations can be done on an outpatient level a priori as by many american health insurance companies expected. 2. Most short operations don't need to be performed in general anaesthesia. Risks and costs can be reduced using local analgesia or "volonelgesie". 3. Such short operations can mostly be done with a single puncture laparoscope, more punctures for additional instruments should only be made if it is necessary. 4. Patients with chronic pelvic pain are able to give support in searching and finding painful organs under "volonelgesia". The treatment of these organs can be performed by injection of a local anaesthetic or in general anaesthesia. That necessitates cooperation between gynecologists, anaesthesiologists, nurses and patients which should be part of educational and training programs.