Laparoscopy

Laparoscopy at a glance

• Laparoscopy 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 causes of infertility.
• Laparoscopy is often used when tests for infertility do not result in a known cause and anatomical issues of the reproductive organs are suspected.
• The laparoscope, a thin tube with camera, allows the surgeon to identify the problem and to utilize the special operating instruments to correct it, all in one procedure.
• In fertility, laparoscopy is used to treat endometriosis, fallopian tube problems, pelvic scar tissue and other anatomical abnormalities.
• Laparoscopy is an out-patient procedure that has benefits over traditional open surgery that include less pain, scarring, blood loss, recovery time and risk of complications, though risks are involved.

Laparoscopy overview

A laparoscopy is an outpatient surgical procedure used in fertility medicine to evaluate and treat endometriosis adhesions, pelvic scarring and fallopian tube blockages. It is a minimally invasive surgery (MIS) used in most medical fields for its efficiency and greatly reduced trauma to the body. The goal is to diagnose and treat conditions in one procedure.

Under anesthesia, a thin tube with a small camera (the laparoscope) is placed through an incision in the belly button, providing the surgeon with a video feed viewed on a monitor. The laparoscope magnifies the tissues in the operating area, giving the surgeon a much better view than with traditional surgery.

Two more small incisions, just above the pelvic bone and slightly toward the left side of the abdomen, allow the physician to investigate the pelvis internally. This includes the ovaries, uterus and fallopian tubes. A gas is administered to inflate the abdomen, providing a better view of the reproductive organs. Sometimes dye will be injected to determine blockage of the fallopian tubes.

A laser can be attached to the laparoscope. Our physicians are expert in laser surgery and prefer to use this method, because the laser causes less tissue trauma and reduces pelvic adhesions after surgery.

We use laparoscopy to diagnose and treat:

• Pelvic scarring
• Endometriosis
• Uterine fibroids
• Ovarian cysts
• Fallopian tube obstructions
• Other structural abnormalities
• Ectopic pregnancy, a life-threatening situation in which the embryo implants outside the uterus.

Depending on the issue being treated, laparoscopy can take from around 45 minutes to over 3 hours. The more involved the condition, such as numerous endometriosis lesions requiring removal, the longer the procedure will take. In most all instances the patient goes home the same day of the procedure.

A hysteroscope also allows an internal view of the uterus but it is inserted through the vagina, not through abdominal incisions as in laparoscopy. Hysteroscopy can be diagnostic and also operative.

Benefits & risks of laparoscopy

A primary benefit of laparoscopy is improved outcomes, which for our patients means a better chance of getting pregnant. Because the surgeon has better access to the operating area, a better view of the affected tissues and organs, and special instruments, the surgical objectives are more often successful. At the same time, the patient’s body is subjected to less trauma caused by large open wounds or incisions.

Other benefits of laparoscopy include:

• Decreased blood loss
• Less pain and discomfort
• Fewer side effects of anesthesia because less is used
• Less tissue trauma due to the fine instruments used
• Reduction in risk of infection
• Smaller scars
• Faster recovery
• Less risk of bone loss, retaining urine and muscle atrophy.

Risks of laparoscopy are similar to those for any surgery. These include reaction to anesthesia, 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.