[Preoperative laparoscopy for determination of the surgical approach].

131 selected patients underwent preoperative laparoscopy directly before surgery and under the same anaesthesia during the period 1981-1984. In all 131 patients several findings were present in combined form that would have permitted abdominal surgery only, provided laparoscopy had not been performed. 49 patients were operated upon via the abdominal approach even though they had been subjected to laparoscopy. In 82 patients, the more favourable vaginal approach was rendered complicated by additional findings (in 22, antefixating preliminary operations on the uterus after Doléris or Baldy; in 29, cystic adnexal tumours; in 31, adhesions or unclear conditions of pain following known or unknown previous surgery). By preceding surgery by laparoscopy it became possible to treat these patients in such a manner that the subsequent vaginal operation was without risk and free from complications. Preoperative laparoscopy extends, enables and safeguards the indication for vaginal surgical approach if used with the necessary critical discrimination.