Laparoscopy is a surgical procedure that involves making one, two or three small cuts in the abdomen through which the doctor inserts a thin fibre-optic tube fitted with light and camera called a laparoscope. Laparoscopy may be used as a diagnostic or as a therapeutic method in infertility. Laparoscopy allows a healthcare provider to visualize the abdominal organs and sometimes even repair few conditions without making a larger incision that can require a longer recovery time and hospital stay.
INDICATIONS FOR LAPAROSCOPY
Possible reasons your doctor may recommend diagnostic laparoscopy include:
- Unexplained pain during sexual intercourse
- Severe menstrual cramps or pelvic pain at other times in your cycle
- Pelvic inflammatory disease (PID) or Pelvic adhesions
- Moderate or severe endometriosis
- In case of suspected ectopic pregnancy.
Often (but not always), if a diagnostic laparoscopy finds problems, the reproductive surgeon will repair, remove, or otherwise treat the issue right away. Laparoscopy surgery may be used to surgically treat some cases of female infertility like –
- Blocked fallopian tube or tubal scarring. Removal of the part of the blocked tube can significantly improve the success of IVF.
- In case of suspected Hydrosalphinx, removing the affected tube can improve IVF success rate.
- If there are endometrial deposits, as these can reduce fertility.
- In case of suspected ovarian cyst causing pain, distorting the uterine cavity or blocking the fallopian tubes.
- In occasional cases of ovarian drilling in PCOS.
PROCEDURE
Laparoscopy is performed in a hospital under general anesthesia. Your doctor will give you instructions on how to prepare for surgery beforehand. You will be asked to not to eat or drink anything for 8 or more hours before your scheduled surgery. Once inside the OT, you will receive an IV line through which fluids and medications will be given to relax you. The anesthetist will cover your face with a mask and you will get an anesthetic in the form of sweet-smelling gas which will put you to sleep.
Once the anesthesia has taken its effect, the doctor will make a small cut around your belly button, through this cut, a needle will be used to fill your abdomen with carbon dioxide gas which helps the doctor to visualize the organs.
The surgeon will evaluate the pelvic organs and the surrounding abdominal organs. The doctor will look for the presence of any cysts, fibroids, scar tissue or adhesions or endometrial growth. Biopsy if required will be taken during this time. Also, fallopian tube can be evaluated for any ectopic pregnancy.
RISKS
As any surgical procedure, laparoscopy comes with risks. Some common complications include –
- Bladder infection after surgery
- Skin irritation around the incision area
- Adhesion formation
- Abdominal wall hematomas
- Infection
Few rare but serious complications include –
- Damage to the organs or blood vessels found in the abdomen
- Allergic reaction
- Nerve damage
- Urinary retention
- Blood clots
- Other general anesthesia complications
- Death
After surgery, the doctor will explain what your options are for getting pregnant. If after a few months after surgery, you do not get pregnant on your own, your doctor may recommend infertility treatment options. Thus, laparoscopy plays a very important role in the diagnosis and treatment of infertility. In case of any queries or assistance, please be free to contact our experts at Fertility Foundation/ SISU Hospital.
