Wir berichten über die spontane Zystenruptur reifer Ovarialteratome einer 40jährigen Frau. Klinisch wurde ein metastasierender Ovarialtumor vorgetäuscht. Beim chirurgischen Staging bestand der Eindruck einer peritonealen und omentalen Metastasierung. Die Gefrierschnittuntersuchung zeigte bilaterale benigne Ovarialteratome und eine chronisch-vernarbende Peritonitis. Malignität konnte nicht bestätigt werden.

At the Department of Gynaecology of the University of Graz laparoscopic aspirations of ovarian cysts are carried out more and more often since 1975 in order to save young women an unnecessary laparotomy. From January 1, 1975 to December 31, 1980 116 ovarian cysts were aspirated and the contents examined cytologically. Thin ovarian cysts were the main indication for aspiration since they were most likely functional cysts. Paraovarian cysts are not suitable for treatment by aspiration because of the high recurrence rate. The results are described and discussed. The recurrence rate of ovarian cysts was 11.1%.

At the department of obstetrics and gynaecology at the University of Graz laparoscopy in the obese women was modified. The pneumoperitoneum is introduced by placing the Verres needle through the pouch of Douglas. An umbilical incision through the fascia is made which admits the index finger of the left hand. Under control by the finger and elevation of the wound with clips the introduction of the trocar becomes safe. The technique is described in detail. The advantages and possible complications of this method are discussed and the first 25 cases reviewed.

The results of 196 cases after operation for cerclage are reported. In 133 patients the operation was performed because of cervical incompetence with opening of the cervical canal without contractions. In 63 patients a prophylactic operation was performed for anamnestic reasons. In the group of cervical incompetence the operation resulted in 103 (94.5%) deliveries, 12 of which occurred before the 35th week of gestation. Following prophylactic cerclage, 46 (78.0%) pregnancies ended with a delivery. In the latter group, the rate of abortions was four times higher than in the group with cervical incompetence. In 82.6% the birth weight was higher than 2,500 g; 4.7% of the newborn only had a body weight below 1,500 g. Before performing cerclage in the 196 patients the abortion rate had been 50.5%, which dropped subsequently to 11.2%. Childbirth at term could be achieved after operation in 73.2% of the patients, compared to the previous figure of 34.4% only.

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