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Laparoscopy
An examination of a woman’s internal pelvic structure can provide important information regarding infertility and common gynecologic disorders. Problems that cannot be discovered by an external physical examination may be discovered by laparoscopy and hysteroscopy, two procedures that provide a direct look at the pelvic organs. These procedures may be recommended as part of your infertility care, depending on your particular situation. Laparoscopy and hysteroscopy can be used for both diagnostic (looking only) and operative(looking and treating) purposes.
Diagnostic laparoscopy may be recommended to look at the outside of the uterus, fallopian tubes, ovaries, and internal pelvic area. Diagnostic hysteroscopy is used to look inside the uterine cavity. If an abnormal condition is detected during the diagnostic procedure, operative laparoscopy or operative hysteroscopy can often be performed to correct it at the same time, avoiding the need for a second surgery. Both diagnostic and operative procedures should be performed by physicians with surgical expertise in these areas. The following information will help patients know what to expect before undergoing any of these procedures.
Laparoscopy is almost always performed under general anesthesia. This means you’ll be unconscious for the procedure. However, you may still be able to go home the same day.Once you’re asleep, a small tube called a catheter will be inserted to collect your urine. A small needle will be used to fill your abdomen with carbon dioxide gas. The gas keeps the abdominal wall away from your organs. It reduces the risk of injury.Your surgeon will make a small cut in your navel and insert the laparoscope, which transmits images to a screen. This gives your doctor a clear view of your organs. What happens next depends on the type of procedure. For diagnosis, your doctor might take a look and then be done. If you need surgery, other incisions will be made. Instruments will be inserted through these holes. Then surgery is performed using the laparoscope as a guide.
Laparoscopy is helpful in:
- Unexplained infertility
- Unexplained pelvic pain
- A history of pelvic infection
- Endometriosis
- Uterine fibroids
- Ovarian cysts or tumors
- Ectopic pregnancy
- Pelvic abscess, or pus
- Pelvic adhesions, or painful scar tissue
- Pelvic inflammatory disease
- Reproductive cancers
Some types of laparoscopic treatment include:
- hysterectomy, or removal of the uterus
- removal of the ovaries
- removal of ovarian cysts
- removal of fibroids
- blocking blood flow to fibroids
- endometrial tissue ablation, which is a treatment for endometriosis
- adhesion removal
- reversal of a contraceptive surgery called tubal ligation
- Burch procedure for incontinence