Laparoscopy: is it replacing clinical acumen?

One thousand sixty-one laparoscopic procedures (80% for diagnostic indications and 20% for therapeutic indications) performed during a 51-month period were reviewed to assess the effectiveness of laparoscopy in improving clinical diagnosis and avoiding major surgery. The error in preoperative clinical assessment as compared to postlaparoscopic diagnosis was approximately 50%: disease was suspected more often than found. Pelvic inflammatory disease, endometriosis, and ovarian cyst were the entities most often confused. Tubal coagulation was the most common procedure performed for therapeutic reasons. The complication rate for all laparoscopies and associated procedures was 2.6%.