Diagnostic and Operative Laparoscopy: Experience in a Teaching Hospital

Abstract

INTRODUCTIONLaparoscopy is an invasive diagnostic, evaluation, and surgical method. Advances in imaging and instrumentation have resulted in an increase in surgical experience; as a consequence, laparoscopy, which was initially used in a few simple surgical procedures such as diagnostic purposes and tubal ligation, has become an acceptable, and even preferred, alternative to open surgical procedures. Compared with laparotomy, laparoscopy has several advantages such as less postoperative pain, small surgical scar, reduced costs, lower bleeding rates, and shorter duration of hospitalization stay (1-3). However, the necessity of surgical equipment and experienced staff, previous abdominal surgery, and patient obesity are factors that limit the use of laparoscopic surgery (2). Depending on surgical experience, a variety of operations ranging from diagnostic laparoscopy to oncological procedures are performed. Here, we aimed to retrospectively analyze the results of diagnostic and operative laparoscopic operations performed in our clinic by reviewing the literature. Statistical AnalysisData were analyzed using the Statistical Package for the Social Sciences (SPSS) software (SPSS Inc.; Chicago, IL, USA) and expressed as means ± standard deviations (mean ± SD) and percentages. RESULTSA total of 503 patients underwent laparoscopic procedures in our clinic. Four hundred and twenty-four (84.2%) patients undergoing 503 L/S interventions were operated due to infertility, and 79 (16%) were operated for gynecological reasons. The mean age was 31.635±7.29 years. Mean gravida and parity was 1.06±1.72 and 0.47±1.11, respectively, and the mean number of abortions was 0.6±1.15. A total of 111 patients (22.07%) were active smokers (Table 1). The mean duration of hospitalization was determined as 1.96±0.5. The mean operative time was 48.85±26.04 min, ranging from a minimum of 15 min to a maximum of 120 min. The operation that lasted the shortest was performed for diagnostic purposes; no gynecological lesion was observed during the laparoscopic examination of the abdomen. The longest operation was laparoscopic hysterectomy performed due to uterine descensus. The difference between pre-and postoperative hematocrit was 2.63±2.53. In total, 100/503 (19%) patients who were operated had a previous history of abdominal surgery (Table 2). Appendectomy was performed in 32 (32%), section in 26 (26%), laparotomy in 20 (20%), myomectomy in 10 (10%), inguinal hernia operation in 7 (7%), and cholecystectomy in 5 (5%) of the 100 The objective of this study was to determine under the view literature, the indications, findings, and complications of diagnostic and operative laparoscopy performed at a teaching hospital.Methods: A total of 503 cases for which the laparoscopy was performed for diagnostic and operative purposes was included into this study. Demographic characteristics, length of operative time, length of hospital stay, conversion rate to open procedure, and complication rates were evaluated.Results: In our clinic, operative laparoscopy ...