Laparoscopy is a surgical procedure for visualization of abdominal and pelvic organs without making a larger incision in the abdomen. A laparoscope is a thin, fibre-optic tube, fitted with a light source and camera. Small cuts are made in the abdomen, through which a scope and specialized surgical instruments are introduced for diagnosis and treatment. Main advantage of laparoscopic procedures is — better visualization of the pelvis, less pain, small scar and early recovery.
Laparoscopy is done either to diagnose or to treat various diseases. It is used to identify a problem and treat it in the same operation.
Tubal and peritoneal pathology account for approximately 30 to 35% of infertility. Direct visualization of the uterus, fallopian tubes, and ovaries during laparoscopy has made it an essential part of infertility evaluation. It becomes valuable when physical examinations, lab tests and scans don’t show exactly what the cause for infertility is. So it’s performed only after other infertility testing has been completed. Some causes of infertility, like endometriosis, can only be diagnosed by laparoscopy. Laparoscopy can be used to determine the stage of certain kinds of cancer. Stage means how far the cancer has advanced.
Allows the doctor to treat a disease or condition. It usually involves removal of diseased tissue or repairing the damage to a structure in the abdomen.
Individuals scheduled for laparoscopy visit the hospital before the operation for pre-operative evaluation and to discuss the procedure in detail. Tests may be ordered, which include blood and urine tests, an ECG, an ultrasound scan and an x-ray.
Laparoscopy is performed under general anaesthesia so you will not feel any pain. You are advised not to eat or drink for 8 or more hours before your scheduled surgery, and antibiotics are prescribed. When you wake up after laparoscopy, you may have a sore throat, caused by a tube that is placed there to help you breath during surgery.
Laparoscopy is safe and it uses only smaller incisions which cause less damage to body tissue and organs compared to open surgery.
Most operations are straightforward, however as with any surgical procedure there is a small chance of side- effects or complications .Risks are divided into those which occur frequently and those which are less frequent but more serious. Women who are obese have had previous surgery, or who have pre-existing medical conditions have an increased risk of the complications. The doctor will discuss the risks and side effects with you.
Similarly, visualizing the uterine cavity and identifying the possible pathology has made hysteroscopy an equally important tool in infertility evaluation. It is combined with Laparoscopy for evaluation and treatment of infertility in the same sitting.
There are risks involved with any procedure. Although this procedure is extremely safe, rarely complications can occur — like Infection, Perforation of the uterus, volume overload in case of prolonged surgical procedure.
Summary
Hysterolaparoscopy is an effective and safe procedure in comprehensive evaluation of infertility, for detecting and treating peritoneal endometriosis, adnexal adhesions, ovarian cysts, polyps, tubal block and septate uterus.
Most of the operations can be done using these new minimally invasive techniques. Gynaecological conditions or procedures which can be performed endoscopically include:
