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RMJ. 2014; 39(1): 48-51

Role of laparoscopy in acute gynaecologic conditions

Muhammad Rafique Memon, Samina Rafiq Memon, Shahid Hussain Mirani, Naila Yousif Memon.

The purpose of this study is to assess the safety, feasibility and efficacy of laparoscopic treatment in acute gynaecologic emergencies as well as to determine its role in current and future practice. This prospective descriptive study was conducted in the department of surgery and Gynaecology, Ghulam Muhammad Mahar Medical College hospital and Hira medical centre Sukkur Pakistan, during a period of last three years from July 2010 to June 2013. Total 48patients admitted with acute gynaecological conditions and were hemodynamically stable, included in the study. Those Patients who were hemodynamically unstable are excluded from the study. All the patients were evaluated by routine blood investigations and ultrasound of abdomen and pelvis .The counseling was done and informed written consent was also taken for open conversion. Initially diagnostic laparoscopy was carried out in all patients by infra-umbilical 10mm port and then inserting another 1 to 2 ports of 5mm as required. The operative findings, outcome of the procedure, hospital stay, intra-operative and post-operative complications were recorded. The data analysis was done on SPSS 12 and compared with national and international literature. The age of the patients ranged between 19 to 43 years. Out of 48 patients, ruptured ovarian cysts were observed in 07(14.58%) patients, torsion of ovarian cysts in 05(10.4%) patients, ruptured ectopic pregnancy in 23(47.9%) patients, pelvic inflammatory disease with tubo-ovarian abscess in 09(18.75%) patients, and pelvic collection in 04(8.33%) patients. All the patients managed laparoscopically, with minimal complications. The intra-operative and post-operative complications observed in the study were minimal bleeding during the procedure which was controlled laparoscopically. Post-operative pelvic pain was observed in 06(12.5%) patients which was relieved by diclofenac suppositories within 2-3 days. Post-operative collection was found in 02 (4.17%) patients, managed conservatively. Open conversion was done in 02(4.17%) patients. Mean hospital stay was 2.3+1.7 days and mean operative time was 55 minutes.The laparoscopy is safe and feasible in the diagnosis and management of gynaecologic emergencies.

Key words: Diagnostic laparoscopy, ectopic pregnancy, adnexal torsion.

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