Objective: To recommend the operative laparoscopic techniques for gynecology.
Methods: Proper application of the technical skills was described on the basis of 878 operations performed laparoscopically. These skills were divided into three groups: level I endocoagulation in 124 cases; level II pretied ligature placement and aquadissection in 653 cases; level III electrosection, electrocoagulation and knottying, suturing in 101 cases.
Results: A total of 866 operations were completed laparoscopically without major intraoperative complications. Twelve cases were converted to laparotomy due to difficulties. The mean operating time for level I, level II and level III group was 49 minutes, 77 minutes and 171 minutes respectively. The incidence of febrile mobidity for level I, level II and level III group was 0.0%, 4.8% and 33.3% respectively. There was one case of postoperative haemorrhage associated with infection in the level III group. However, no major post-operative complications occurred in the level I-II group and the clinical outcome including the overall patients satisfaction was good.
Conclusion: Mastery of operative laparoscopic techniques step by step along with the degree of surgical difficulty is madatory, and can deliver optimal clinical outcome hopefully. It will also help to expand the use of operative gynecologic laparoscopy in a safe and effective way.