Laparoscopic abdominoperineal resection confers definite health-related benefits the over open approach in terms of reduced septic complications and fewer requirements for blood transfusion. It should be considered the procedure of choice for patients with low rectal or anal canal tumour in whom sphincter excision proved inevitable.

Deeply infiltrating endometriosis was described in the early part of the last century. Only recently, has there become a greater awareness and understanding of this form of endometriosis aided in part by advances in laparoscopic surgical technology in techniques. The clinical implications of the disease as well as diagnosis and current management are reviewed.

Dysmenorrhea can be a severe and debilitating symptom in many women. Although most women may find adequate relief of symptoms from pharmacological approaches, there remain a few with resistant pain. Presacral neurectomy, although technically challenging, may be offered after other approaches are unsuccessful. The operation is now performed increasingly by the laparoscopic approach, which has revived this operation in some centers. The anatomy, technique, and indications as well as a review of the literature supporting this operation are reviewed. The potential complications of this operation are discussed also.

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Objective The purpose of this study is to provide safe guidelines to minimize the risk of fluid absorption and its complications at operative hysteroscopy. Design Retrospective review of the literature. Results Two of the major complications of fluid intravasation at hysteroscopic surgery are hyponatraemic encephalopathy and death. Fluid intravasation remains a risk despite optimal instrumentation and the use of minimal pressures to distend the uterus. While multiple factors affect the amount of fluid absorption and significant variability can exist between very similar cases, monitoring of fluid balance remains the most important issue. Techniques relying on volume measurements are less accurate than those using weight measurements and can potentially lead to significant underestimation of fluid absorption. A continuous automated weighing system provides an easy, less time‐consuming and valid method of monitoring fluid deficit. We believe the safe limit for accurately measured fluid loss should be 800 mL, as 1000 mL of glycine intravasation results in a very significant decrease in serum sodium which is sufficient to bring a normonatraemic patient into the abnormal range. It is safer to perform hysteroscopic surgery under local anaesthesia as the earliest symptoms of encephalopathy, i.e. nausea, vomiting, weakness, will alert the surgeon and anaesthesist about impending serious complications, and corrective measures can be taken earlier than when the patient is under general anaesthesia. Conclusion Fluid overload with subsequent hyponatraemic encephalopathy and death is one of the most significant complications in operative hysteroscopy. Following a protocol which entails the use of local anaesthesia and accurate fluid monitoring and sets a limit to fluid deficit will minimize this risk.