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PubMed1988

[Distribution of the incidence of various pelviscopic (laparoscopic) surgical procedures and their complication rates. A statistical analysis in West Germany 1983 up to and including 1985].

The 3rd German pelviscopy (laparoscopy) statistics includes in all 207,823 laparoscopies from 310 clinics and 41,644 laparoscopies from 121 private practises. This is a percentage of 39% from clinics and 59.3% from private practises. There appeared 429 serious complications in the clinics and in the practises 63, which is a complication rate of 1.97%. In 415 cases (1.66%), a laparoscopy was required. The most important of the complications was injury of the intestinal organs, when putting in the Veress-needle or the optical trocar, followed by injury of the main blood vessels, as well as hemorrhages of the salpinges on detached omental fragments. Where tubal sterilization is concerned, 87.7% of the clinics ans private practises used the bipolar HF technique; 32.4% used the endocoagulation according to Semm. In 8.3% of the cases, the monopolar high frequency method was applied. After sterilization in the clinics, 2.8% intra- and extrauterine pregnancies occurred, while in the private hospitals this percentage was 3.3%. The intra- or extrauterine pregnancies occurred mainly after sterilization by the bipolar HF technique or after clip-sterilization. 46.1% of the investigated clinics and 36.4% of private practises, intend to increase the indication of endoscopic operational methods.

Cross-Sectional Studies↗
PubMed1992

Pelviscopy/laparoscopy and its complications in Germany, 1949-1988.

The fourth German pelviscopy/laparoscopy statistical report includes survey data on a total of 219,314 laparoscopies from 354 clinics and 40,892 laparoscopies from 161 private practices. Clinics' response rate was 44.7%; 98.9% of them reported performing laparoscopies; and the number of serious complications requiring laparotomy or control laparoscopy was 492 (2.2/1,000). For private practices, the comparable figures were 66%, 90.8% and 123 (3/1,000), respectively. Compared with data from the third laparoscopy statistical survey, the data show a slight increase in serious complications, most of which were mechanical lesions of blood vessels in the abdominal wall or in the mesosalpinx, followed by mechanical lesions of the intestine. As shown by the previous survey, 16.5% of the complications were burns. For tubal sterilization, bipolar techniques were still predominant; approximately equal numbers of departments used this method, with or without subsequent transsection of the tubes. Endocoagulation by the method of Semm was the second most popular procedure; the use of clips and rings was of little significance. Monopolar high-frequency (HF) current was still used with transsection by 4.1% of clinics (4.7% of private practices) and without transsection by 2.5% (5.3%). Sterilization failure rates remained the same as those previously reported (4.6/1,000 in clinics, 5.3/1,000 in private practices); the highest rates were observed after the use of monopolar HF techniques. Sixty-six percent of the clinics and 41% of the private practices reported their intention to increase the use of endoscopic operational methods.

Female↗
PubMed1979

Sterilization: a comparative review.

Publications relating to surgical procedures for sterilization have been reviewed, and the incidences of complications and subsequent pregnancies compared. Laparoscopic sterilization has the lowest incidence of complication, the morbidity rate being lower than that of laparotomy sterilization or hysterectomy, and the mortality rate lower than that of a single pregnancy or taking oral contraceptives for 1 year.

Female↗
PubMed1990

American Association of Gynecologic Laparoscopists 1988 Membership Survey on Laparoscopic Sterilization.

The 1988 Membership Survey of the American Association of Gynecologic Laparoscopists (AAGL) indicated that the membership continues to perform fewer sterilizations than previously reported. The respondents reported performing 30,480 sterilizations, 41,160 diagnostic laparoscopies and 13,920 hysteroscopies. The distribution of laparoscopic sterilizations by method of tubal occlusion has not changed appreciably since 1985. Complications from diagnostic laparoscopy are consistently higher than those after sterilization; two deaths (4.8 deaths per 100,000 procedures) were identified after diagnostic laparoscopy and no deaths were reported after sterilization. The relative likelihood of ectopic pregnancy is substantially greater after coagulation procedures than after mechanical ones. The decrease in membership performance of laparoscopic sterilization is occurring at the same time as a relative increase in the performance of newer diagnostic and therapeutic endoscopic procedures.

Female↗