Stop unnecessary gynecologic endoscopic surgery

Thanks to the marvelous developments in illumination and instrumentation, the indications of endoscopic surgery in gynecologic practice have been expanded to cover most of gynecologic subspecialties. Some gynecologists, after gaining basic knowledge following a training course or a three-day workshop, use endoscopy frequently whether or not indicated. This can be attributed to a desire to get hands-on-experience before being engaged in busy heavy clinical work, self satisfaction after gaining this limited experience, overenthusiasm with the technology, propagandism for the doctor or as a trial to gain money. Some doctors decide to perform an endoscopic operation and get the patient’s consent but after starting the procedure they fail to detect an indication for the surgery, so they do any procedure to convince the patient that she got some benefit. Myolysis in infertile women is a good example of a harmful unneeded laparoscopic procedure. Since a long time ago, it has been well known that this procedure is reserved for women over 40 years who completed their families [1]. If it is done for women seeking fertility, extensive adhesions are invited. The ovaries are the organs that are most exposed to unneeded and even harmful maneuvers. Laparoscopic ovarian drilling (LOD) is commonly performed in many parts of the world particularly in low resource countries that do not cover the expenses of HMG therapy and ICU management of its possible complications. Due to lack of sufficient sonographic experience, some cases of LOD