Some countries have established standards based on the difficulty of laparoscopic surgery. According to these standards, the level of each physician can be measured and surgical skills can be evaluated. The easiest surgery includes sterilization, ovarian cyst removal, infertility check and ectopic pregnancy surgery. Moderately difficult operations include removal of fibroids smaller than 4cm, adhesion separation, oophorectomy, bladder neck pubic comb ligament suspension, and simple laparoscopic combined vaginal hysterectomy. The most difficult operations include separation of extensive pelvic adhesions, bowel in severe endometriosis, separation of vaginal and rectal adhesions, pelvic tissue repair, laparoscopic assisted vaginal hysterectomy with comorbidities, and pelvic lymphadenectomy And extensive hysterectomy. According to this standard, 50% of gynecologists in Australia use laparoscopy for ectopic pregnancy, and only 8% of hysterectomy is done under laparoscopy. This shows that most gynecologists lack simple laparoscopic surgery training, and only a few gynecologists can perform simple laparoscopic hysterectomy.
It can be widely used only when government health agencies, insurance companies, national professional medical organizations (such as the Society of Obstetrics and Gynecology), and patients who need surgical treatment recognize the safety, therapeutic effect, and reasonable price of laparoscopic surgery. If the government health agency recognizes the value of endoscopic surgery, it will provide financial support and establish a training center to enable most doctors to participate in the training and quickly become endoscopic surgeons. When the clinical value of laparoscopic cholecystectomy was recognized, it took only one year for its popularization in developed countries. Surgeons only use this method to perform cholecystectomy, which is beneficial to the government, patients and insurance companies.
Due to lack of funds, developing countries cannot purchase equipment, train enough teachers, and participate in national and international conferences to acquire new knowledge and technical materials. Some international organizations such as WHO, IsGE and the International Society of Endoscopy have begun to assist developing countries in carrying out endoscopic surgery.
The operation steps of any operation need to be mastered by understanding and memorizing two methods. Based on the knowledge of anatomy and pathology, the commonly used ovarian resection procedures are described here to make the operation safer and more effective.
