Laparoscopy is certainly the most important progress of the last decades in surgery. Promoted in 1940 by Raoul Palmer to exclusively diagnostic in the context of the exploration of female infertility, laparoscopy became, in half a century, a surgical discipline in itself, both in gynecology and in many other specialties [1] . The field of his indications has considerably enlarged and his contraindications have been reduced with the development of the material and the instrumentation and the progress of anesthesia and resuscitation. The practice of minimally invasive surgery in Senegal occupies more and more of a preponderant place in fields that previously did not allow it. Thus, in our practice in gynecology, we are witnessing an explosion of these operating indications especially for benign adnexal pathology.

This is a retrospective and descriptive study that focuses on a continuous series of cases of laparoscopy in diagnostic or operative at the National Hospital of Pikine. We collected all patients who underwent laparoscopic intervention in the department during the study period from January 1, 2012 to December 31, 2016 (60 months). For each patient, we compiled an individual survey form and studied the following parameters: socio-demographic and clinical parameters such as age, gestity, parity, antecedents and causal pathology; operative data, in particular indications, the progress of the laparoscopic act, the gestures possibly made, as well as the incidents and the operating difficulties and finally the operative follow-up in the short, medium and long term. We excluded cases where records were not available. Data were collected from patient charts, operative report cards, and patient interview data by telephone to complete missing information and sign their consent.

This data was captured and analyzed using the Sphinx version 5 software. The graphics were made by Microsoft Excel for Windows 2016. The correlation examination and the significant risks that existed between the variables during the analysis were performed using adequacy and comparison tests. The Chi-square test was used for comparisons. The tests were significant as soon as the associated probability was less than 5%. We used the null hypothesis if α was less than 0.05. If the null hypothesis was rejected, we proceeded to the analysis of the relation. Otherwise, the relationship was simply removed from the study.

In our study, we found some limitations such as the retrospective nature and some missing data in the files that we tried to fill during the interviews and finally the small size of the cohort.

We obtained the following results.

Endoscopic surgery accounted for 20.1% of all gynecological and breast interventions performed between 2012 and 2016 (Table 1). There were 195 cases (14.9%) of laparoscopic surgery and 69 cases (5.2%) of operative hysteroscopy.

Overall, we observe a remarkable evolution of the frequency of the endoscopic approach from 2016, when it was stable from 2012 to 2015. This considerable increase in endoscopic surgery (laparoscopic surgery and operative hysteroscopy) contrasts with a relatively slight decrease in laparotomy (Figure 1).

The average age of our patients was 34 years with extremes of 15 and 67 years. The highest age frequency was between 31 and 40 years of age representing 46.9 to 7.4% of the workforce.

We counted 35 patients with a history of abdominopelvic surgery including a laparoscopic procedure and 34 cases of laparotomy. Among these antecedents of laparotomy we know 8.5% ovarian cystectomy, 7.3% caesarean section, 2.4% myomectomy, 1.2% for ectopic pregnancy cure. Most patients were followed for infertility, this was the case for 108 cases, or 61%. In the other situations (41 patients, 23.1%), pelvic pain was present and 3.3% for a pelvic mass 8.5%.

The interventions were motivated by the exploration or management of infertility in 101 cases, or 57.1% of patients. Tubal obstruction was found in 20.3% of cases