These newly developed endoscopic methods in gynaecology for haemostasis during surgical pelviscopy (Endocoagulation Roeder-loop ligation, endoligature, endo-suture with intra- and extracorporeal knotting) make it possible to carry out appendectomy by endoscopy for any of the following indications: Postoperative adhesion of the appendix especially in "sterility" patients, elongated appendix extending into the small pelvis, endometriosis of the appendix, subacute and chronic appendicitis. The instrument-set employed in this method permits the performance of all the usual classical operative steps (purse-string suture, and Z-suture acc. to McBurney and Sprengel). The point for resection has to be sterilized over 20-30 sec. at 212 degrees F using the crocodile forceps (endocoagulation procedure) before division and extraction of the appendix is effected.

The development of suitable instruments for perfect grasping, cutting, sucking, ligating and of a new system of performing hemostasis by endocoagulation through a 7--11 mm phi trocar-sheath enables us to initiate effective endoscopical intraabdominal surgery. New surgical techniques are being investigated on greater than 2.000 cases of surgical pelviscopic interventions which were performed between 1973--1976. Since 1977 we have extended the endoscopical intraabdominal surgery as follows: Myomectomy (subserous), adnectomy, ovarian-cyst-resection, cystomectomy, tubectomy in case of tubal pregnancy. In 115 cases no intra- or postoperative complications have occurred. Normal postsurgical healing procedure could be checked on 18 re-pelviscopies and on 2 later laparotomies. The new technical equipment has opened us together with special surgical procedures a new era of gynecologic surgery.

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The presence of immunocompetetive cells in the endometrium during the proliferative and secretory phase of the ovarian cycle is demonstrated on the light and electron microscopic level using monoclonal antibodies (MoAb). Subtypes of monocytes, macrophages and T-lymphocytes appear during the different phases in variable extent and different localization. Some subpopulations of the monocyte/macrophage system and T-helper lymphocytes increase in number on day 21/22. Our observations indicate that cells with bone marrow origin take part in functional events of the endometrium during the ovarian cycle.

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