Moreover, only 5% (29/540) commented on the pelvic sidewall peritoneum without selleck inhibitor specifying whether the ovarian fossa and the peritoneum overlying zone IV were evaluated. Overall, only 6% (n = 34, 95% CI: 4�C8) reported either positive and/or negative findings in the various pelvic zones resulting in complete documentation of the presence or absence of pelvic findings (Table 2). Supplemental photographic documentation of all pelvic areas was frequently missed; it was found only in 6% (n = 34, 95% CI: 4�C8) of patients’ charts. Table 2 Percentages of the surgical reports that described findings in any structure or all structures of every pelvic zone. 4. Conclusion The paucity of detail in operative reporting represents a missed opportunity to document important anatomical findings that could prove useful in future patient care.

Our retrospective chart review demonstrated that description of important pelvic structures is frequently missing in operative notes from diagnostic and operative laparoscopy. The anterior cul-de-sac, deep inguinal rings, ovarian fossa, and the lateral pelvic sidewall peritoneum are the most frequently missed areas. Photographic documentation of normal and abnormal findings was also frequently missed. As seen in the general surgical literature, standardizing operative reporting improves completeness of documentation [2]. If such systems are in place, residents can be taught these methods for reporting during their training [3, 4]. As the era of digital photography and electronic medical records evolves, this is a very appropriate time to innovate with respect to the methods by which we document our surgical findings.

Implementation of a systematic approach for laparoscopic pelvic examination will indeed enhance the diagnostic accuracy, help diagnose lesions in anatomically challenging locations, and provide the required standardization with its clinical and academic advantages. Templates have been created to achieve standardization in general operative reports [5]. Photographic documentation of these anatomic regions would provide an additional advantage. We recommend a minimum of 6 photographs of the 6 pelvic zones in the absence of pelvic pathology. These six zones are depicted in Figure 1. Images of these zones will supplement the report. In addition, if surgeons dictate according to the zones, comprehensive details will be incorporated into the description report.

Two copies of photos should be available for charting. In summary, a comprehensive description of important pelvic structures is frequently missing in operative notes from diagnostic and operative laparoscopy. The anterior cul-de-sac, deep inguinal rings, and the lateral pelvic sidewall peritoneum are the most frequently Cilengitide missed areas. A large proportion of gynecological surgery utilizes operative and diagnostic laparoscopy.