Semm K
Wien Klin Wochenschr. 1983 May 27;95(11):353-67.
Modern technique leads to abdominal surgery under "miniature" conditions. The combination of electrically monitored pneumaperitoneum, cold light optic, new mini-instruments, the newly developed hemostatic procedure "endocoagulation" (the patient is not in contact with the electrical current) and intraabdominal ligation techniques allows a new spectrum of operative procedures to be performed in gynecology. The following endoscopic gynecological operations have become routine: adhesions, ovario- and fimbriolysis, sharp and blunt opening of the ampulla tubae (sterility-operations), enucleation of pedunculated subserous myomas, conservative and radical tubal therapy of ectopic pregnancy, ovarian biopsy, ovarian cyst enucleation, ovarectomy ("3-sling-technique"), coagulation of endometriosis, tubal ligation. As examples of non typical gynecological operations in general surgery, omental adhaesiolysis, lysis of bowel adhesions and appendectomy can be mentioned. These new operative techniques have been developed in more than 10,000 pelviscopies. They stand for laparotomy in up to 80% of all cases in tubal and ovarian surgery. The complication rate lies in the area of 2%. Hospitalization has diminished by more than 50%, the period of reconvalescence by more than 75%.
现代技术使得腹部手术能够在“微创”条件下进行。电子监测气腹、冷光光学、新型微型器械、新开发的止血方法“内镜下凝固术”（患者不接触电流）以及腹腔内结扎技术的结合，使得妇科领域能够开展一系列新的手术操作。以下妇科内镜手术已成为常规手术：粘连松解术、卵巢及输卵管伞端松解术、输卵管壶腹部锐性及钝性开口术（绝育手术）、带蒂浆膜下肌瘤摘除术、异位妊娠的保守性及根治性输卵管治疗、卵巢活检、卵巢囊肿摘除术、卵巢切除术（“三吊带技术”）、子宫内膜异位症凝固术、输卵管结扎术。作为普通外科非典型妇科手术的例子，可以提及大网膜粘连松解术、肠粘连松解术和阑尾切除术。这些新的手术技术已在10000多例腹腔镜手术中得到应用。在输卵管和卵巢手术中，它们在高达80%的病例中替代了开腹手术。并发症发生率在2%左右。住院时间减少了50%以上，康复期缩短了75%以上。
