Laparoscopy

Laparoscopy may be a minimally invasive procedure performed through small incisions to look at the organs within the abdominal region and so diagnose the condition for additional treatment.

Laparoscopy

Laparoscopy is an outpatient surgical procedure used in fertility medicine either for evaluation or treatment. It is a minimally invasive surgery involving small incisions through which a tiny camera and operating instruments are passed into the pelvic region to diagnose and correct the causes of infertility. Laparoscopy is often used when tests for infertility do not reveal any known cause and anatomical issues of the reproductive organs are suspected. Laparoscopic surgery is much less traumatic for the body than traditional types of surgery which use large incisions. Patients experience less pain, discomfort, and dramatically quicker recovery times.

When is it done?

Laparoscopy is considered the gold standard for diagnosing and correcting fertility problems, as not all pelvic problems may be visible through routine evaluations like ultrasounds. There are different types of laparoscopies.

It can be diagnostic, assessing for causes of infertility in the uterus, fallopian tubes and ovaries. Or, it can be an operative procedure that involves surgical treatment for problems found during a diagnosis, such as surgery to remove scar tissue or endometriosis.

Laparoscopy is used to diagnose and treat

  • Pelvic scarring
  • Endometriosis
  • Uterine fibroids
  • Ovarian cysts
  • Fallopian tube obstructions
  • Ectopic pregnancy
  • Other structural abnormalities

How is it done?

Laparoscopy is performed in a hospital under general anaesthesia. Once the drug has taken effect, the doctor will make a small cut around the belly button. Through this cut, a needle will be used to fill the abdomen with carbon dioxide gas, after which a tube called 'cannula' is inserted. The cannula has multiple functions, mainly used to insert the laparoscope and other surgical instruments into the body. The camera provides the surgeon with a video feed of the reproductive organs, which can be viewed on a monitor. This magnifies the tissues in the operating area, giving the surgeon a much better view than with traditional surgery.

Two more small incisions are made, just above the pelvic bone and slightly toward the left side of the abdomen, allowing the physician to investigate the pelvis internally, including the ovaries, uterus and fallopian tubes. In some cases, a dye will be injected through the cervix to determine blockage of the fallopian tubes. If the fallopian tubes are blocked, they may be opened. Adhesions, endometrial growths, cysts, and fibroids may be removed in some cases. Even if no signs of endometriosis or other problems are found, the surgeon may remove a sample of tissue to be tested. If an ectopic pregnancy is suspected, the surgeon will evaluate the fallopian tubes for abnormal pregnancy.

Depending on the issue being treated, laparoscopy can take from around 45 minutes to over 3 hours.

Benefits of Laparoscopy

Laparoscopy has many benefits over traditional surgery

  • Improved outcome or success rate of surgery
  • Fewer and smaller incisions, with less invasive methods
  • Decreased blood loss
  • Less pain and discomfort
  • Fewer side effects of anaesthesia
  • Less tissue trauma due to the fine instruments used
  • Reduction in the risk of infection
  • Smaller scars
  • Faster recovery
  • Less risk of bone loss, retaining urine and muscle atrophy

The risks of laparoscopy are similar to those for any surgery. These include reaction to anaesthesia, blood loss, tissue and organ damage, scarring and pain. If an organ is damaged during the procedure, a larger incision may be needed to facilitate repair of the issue. This would generally result in a hospital stay. Still, laparoscopy is advantageous because depending on what is wrong, the surgeon may treat the problem during the same surgery. After surgery, the doctor will explain what the options are for getting pregnant, whether to try for normal conception or further fertility treatments.