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  • Title: [Microsurgery in gynaecology: endocoagulation, a new method for operations in pelvic endoscopy (author's transl)].
    Author: Semm K.
    Journal: Geburtshilfe Frauenheilkd; 1977 Feb; 37(2):93-102. PubMed ID: 557014.
    Abstract:
    Hemostasis by high frequency current in the abdomen is too dangerous during pelvic endoscopy. Pelviscopy was therefore mainly a diagnostic procedure. Modern electronic coagulation instruments such as the Crocodile forceps and the point coagulator today permit the application of destructive heat without electrical risk for the patient in the peritoneal cavity. The electronic monitor for this coagulation instrument, the endocoagulator gives an optical and acoustical record of the coagulation temperature. The endocoagulation technique permits reorientation of gynaecological surgery to a new micorsurgical technique. Operations for sterilization the lysis of adhesions, the treatment of endometriosis and ovarian cysts in young people reduces the need for laparotomy by 40 to 50% when modern endocoagulation is used. Endocoagulation can now be recommended as routine technqiue for every pelvic endoscopic operation. In 2715 pelvic endoscopies, destructive heat was used in 47% of the cases and the complication rate was 1.3%. An endocoagulation method in conjunction with pelvic endoscopy can be used in place of laparotomy for performing tubal sterilizations, separation of adhesions, coagulation treatment of endometriosis, and coagulation to stop bleeding after an ovarial biopsy. The bipolar high frequency current used does not use the body tissues as conductors, avoiding the generation of destructive heat in any but the desired area. Electrical current does not come in contact with the body tissues; the heat is generated in a specially designed crocodile forceps for tubal sterilizations and a point coagulator for the other operations. The heat is variable between 50-200 degrees C and has optical and acoustical gauges for recording the temperature. 2715 pelvic endoscopies were performed, destructive heat was used in 1279 of the cases. A complication rate of 1.3% was reported.
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