Survey of gynecologic laparoscopy for 1974.

Abstract

A survey of physicians performing laparoscopy was made by the Complications Committee of the American Association of Gynecological Laparoscopists in 1974 to clarify possible cause and effect relationships between observed complications and factors such as: 1) operator experience; 2) specific operative techniques; 3) preferred setting; and 4) the surgical setting. 1030 physicians were surveyed with a response rate of 86.2% (886). Laparoscopic technique was described. Most used carbon dioxide for insufflation 46.6% used a solid state power source and 34.2% a spark gap power source 61.5% used 11-20 mm Hg pressure during laparoscopy a normal distribution of gas volumes - 47.8% using 2-3 liters and an equal number performed tubal ligation with or without obtaining a specimen at coagulation. 872 physicians reported a total of career experience with laparoscopy of 236253 operations 3% performing 30% of the diagnostic operations and 6% performing 35.5% of the sterilizations. Failure rate for sterilization was 1.89/1000 cases. More than 90% of the physicians preferred general anesthesia. The double puncture technique was preferred by 61.4% performing sterilizations. 30% of the respondents reported a failed attempt with diagnostic and sterilization procedures. The physicians experience was related to failed Attempt in diagnostic laparoscopy and also to the need to perform unexpected laparotomies with marked reduction after 250 diagnostic operative experiences. Death rate was .85/10000 cases for diagnostic procedure and .75/10000 for sterilization. Pregnancy rate after sterilization was 3 times higher in physicians with less than 100 operations experience. One-hole sterilization showed a lower complication rate than double puncture procedure as did the technique of coagulation without division.