The use of laparoscopic and hysteroscopic access for gynecologic
surgery is now state of the art. However, acceptance
of these surgical access routes and their incorporation
into daily gynecologic practice has been slow and took
well over two decades. Yet the advantages of laparoscopic
access as opposed to conventional laparotomy were
already evident more than 30 years ago. These advantages
include shortened post-operative hospital stay and recovery
period; reduced post-operative discomfort which
results in less analgesia requirements; frequently lesser
costs; and the ensuing medical and cosmetic gains associated
with the avoidance of a laparotomy. Many more
complex gynecological procedures can now be successfully
performed by laparoscopy. The most telling of these developments
has been the use of laparoscopic access for pelvic
and para-aortic lymphadenectomy and radical hysterectomy
for gynecologic malignancy.
In the 1970s hysteroscopy was