The development of laparoscopic surgery.

For centuries people have been trying to look inside the abdomen but it is only relatively recently that the technology has been available to make this a meaningful possibility. Major milestones have included safe peritoneal insufflation, cold-light illumination, laparoscopes with the rod lens system, instruments for the safe manipulation of pelvic organs, techniques to ensure haemostasis, laser, video monitoring and most recently double-optic laparoscopy. As a result, the indications for gynaecological laparoscopy have been greatly extended from its initial use as a diagnostic aid or a means of female sterilization, and procedures such as adhesiolysis, ovarian cystectomy, tubal surgery for infertility or ectopic pregnancy, excision of endometriosis and even myomectomy are now possible without open surgery. Well-defined safety guidelines must of course be adhered to and proper training is essential in the various techniques, but the medical, financial and social advantages are such that we owe it to our patients to exploit the full potential of this new mode of management.