(A) Indications
Class I.
1. Fine needle puncture in the bursa: e.g. puncture of flavin cysts ＼ ovarian duct cysts.
2.Biopsy: e.g. biopsy of the ovary.
3.Local injection of drugs: such as local injection of methotrexate (MTX) or 5-fluorouracil (5-Fu) for ectopic pregnancy or trophoblastic tumors.
4.Separation of mild pelvic adhesions, such as membranous adhesions or a small amount of corded adhesions.
5.Laser or electrocoagulation for endometriosis with American Fertility Society (AFS) score of I-II.
6.Laparoscopic treatment of polycystic ovary syndrome.
7, Local hemostasis and abdominal clearance for ruptured corpus luteum.
Class II.
1, tubal linear incision for tubal pregnancy to remove the embryo sac.
2.Ovarian cyst enucleation, such as ovarian chocolate cysts and dermatomal cysts.
3, resection of benign tumors of the fallopian tube or ovary (liquid dark area on ultrasound, thin wall of the cyst, single atrial diameter <8cm, CA125 measurement within normal range, etc.).
4.Adnexal resection
5.Laparoscopic tubal sterilization.
6.Laxation of moderate and severe pelvic adhesions and separation of abdominal adhesions.
7.Wound repair of uterine perforation.
8.Treatment of some infertility diseases, such as tubal ostomy
9.Uterus repositioning surgery, such as uterine draping
10.Uterine subplasma myoma or small intermural myoma excavation.
11, Assisted reproductive technology, laparoscopic oocyte collection, gamete intrafallopian tube transplantation.
12, Treatment of endometriosis AFS class III-IV.
Class III.
1, Excision of larger intermural myomas (myoma diameter >5cm).
2.Subtotal hysterectomy and total hysterectomy (SEMM style).
3.Laparoscopic-assisted negative hysterectomy (LAVH).
Class IV.
Pelvic lymph node dissection.
(II) Contraindications
1, Same as laparoscopy.
2, pelvic malignancy is still as a contraindication to laparoscopic surgery.
3, endometriosis without fertility requirements, and heavy symptoms, large uterus, suspected myxoma, bilateral large chocolate cysts, significant parametrial thickening, lesions have invaded the posterior fornix.
4.Patients with ectopic pregnancy with shock and a mass >5cm, pregnancy in the interstitial or broad ligament, and heavy adhesions.
5.The number of fibroids is more than 3 and the single diameter is >8cm, as a contraindication to myomectomy.
6.For large uterine fibroids and those with fibroids located near blood vessels, LAVH should be chosen with caution.