MICROLAPAROSCOPY - A COMPARATIVE-STUDY OF DIAGNOSTIC-ACCURACY

Objective: To investigate the diagnostic accuracy of microlaparoscopy in comparison to laparoscopy with a standard 10-mm laparoscope. Design : Prospective evaluation by two independent observers. Setting: Academ ic Medical Center. Patient(s): Ten patients scheduled to undergo diagn ostic laparoscopy for the indications of infertility and/or chronic pe lvic pain. Intervention(s): Two surgeons were present for each operati on. Diagnostic laparoscopy was performed using the Microlap 2-mm lapar oscope (Imagyn Medical Inc., Laguna Niguel, CA). Standard diagnostic l aparoscopy was then performed using a 10-mm laparoscope. After each pr ocedure, each surgeon reported his or her observations in a confidenti al manner to a third person to record. Main Outcome Measure(s): Endome triosis and adnexal adhesions were staged. Observations made with the microlaparoscope were compared with those obtained with a standard 10- mm laparoscope for each surgeon. The observations of both surgeons wer e also compared with each other's to evaluate interobserver difference s. Result(s): Operative findings reported by each individual surgeon u sing the microlaparoscope correlated with the operative findings repor ted using the larger laparoscope. Scores for both endometriosis and ad nexal adhesions did not differ in any significant way. Endometriosis s cores differed by no more than 6 points, and adhesion scores differed by no more than 2 points, with no subsequent change in severity classi fication for either finding. Furthermore, when comparing the additiona l operative findings of the two surgeons, no difference was noted when using either the microlaparoscope or a standard 10-mm laparoscope.Con clusion(s): The diagnostic accuracy achieved with microlaparoscopy is comparable to that achieved with standard 10-mm laparoscopy. (C) 1997 by American Society for Reproductive Medicine.