[Laparoscopic interventions in gynecology].

Gynecological surgery is performed in a difficult anatomical area of vital organs close to the pelvic wall. It requires precise hemostasis to prevent blood loss and postoperative complications. Both blood loss and complications are reduced by pelviscopic operation techniques. Patients who undergo gynecological pelviscopic operations often experience in comparison to laparotomy less fever, require less postoperative analgesia and are able to tolerate a full diet within 24 hours of surgery. Very often they have a faster recovery and a shorter hospital stay than patients undergoing traditional abdominal or transvaginal operations. The endoscopic operative technique lays the foundation for minimal invasive surgery. The mainly organ-resecting gynecological laparotomy, aiming to avoid recurrence, is increasingly being replaced by pelviscopic organ preservative techniques. Meanwhile we tend to perform many hysterectomies laparoscopically assisted (LAVH). It avoids laparotomy in casesa of adhesions and high uterine tissue mass and seems to lower intraoperative risks such as infection by strong operative restriction of the vaginal approach. CISH (classic intrafascial SEMM hysterectomy, SEM*M denoting "serrated edge macro-morcellated") even leaves the pelvic floor intact. Furthermore, we perform pelviscopic operations in cases of endometriosis, benign tumors of the ovaries, ectopic pregnancies and genital malformations (i.e., Vecchietti genitoplasty in the MRK-syndrome).