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Laparoscopic Procedures for Reproductive Surgery

Off late there has been a substantial increase in the percentage of women suffering from some degree of infertility or perhaps having other gynecological problems. In some cases, couples may indeed find that they can conceive naturally after surgery in order to restore normal reproductive function. Some of the conditions requiring surgical intervention do include but are not, of course, limited to a fibroid uterus, endometriosis, tubal blocks, ovarian cysts, polycystic ovaries, pelvic adhesions as well as chronic abdomen pain.

Traditionally, in case women suffering from such conditions are planning for a surgery, it would be rather an open surgery which does comes with side effects that include increasing pain, a minimum scar of 10 cm with stitch marks, increased blood loss that have been added to blood transfusion and its complications, increased chance of wound infection, longer duration to recover post surgery and also to resume daily activities, increased dependency on others and long duration of hospital stay and leave from work. The solution to be able to reduce the stress induced by open surgery is Laparoscopy. Carbon dioxide gas is allowed to flow into the abdomen prior to inserting the laparoscope.

The laparoscope is no doubt a thin fiber optic telescope which is less than a centimeter, which is inserted into the abdomen. The fiber optics does allow a light which is made use of to see inside one’s abdomen.

Laparoscopy can either be diagnostic or even therapeutic. Generally, laparoscopy does need to be reserved for couples who have already completed a more basic infertility evaluation, that does include assessing ovulation, ovarian reserve, ultrasound as well as hysterosalpingogram for female and semen analysis for a male.

Some conditions such as pelvic adhesions as well as minimal endometriosis along with chronic abdomen pain can be diagnosed only via laparoscopy and can also be treated at the same time if the required expertise is available. This does provide immense symptomatic relief to the patient.

In case a tubal block is diagnosed through hystero-laparoscopy, it can also be corrected by cannulation of the tube with expert assistance. Other indications as far as laparoscopy is concerned are fibroid removal, poly cystic ovarian drilling, and clipping of infected tube before IVF/ICSI in order to improve the success rate. Laparoscopy does come with the advantages of day care surgery which is more cosmetic than no pain or blood loss and also easy recovery from surgery. Patients can also resume day to day activities in a day or two.

What methods?

Diagnostic as well as Operative Laparoscopy for:

• Endometriosis, adhesions as well as tubal occlusion
• Diagnosis and treatment of the pelvic pain
• Myomectomy
• Diagnosis of cum treatment of adnexal masses and ovarian dysfunction

Hysteroscopy for:

• Myomectomy
• Polypectomy
• Adhesions
• Septum Resection
• Tubal Cannulation
• Microscopic Tubal Ligation Reversal
• Locations for Reproductive Surgery

Diagnostic Laparoscopy

Laparoscopy is, of course, an outpatient procedure. It is Performed under general anesthesia in order to diagnose and also treat endometriosis as well as tubal disorders, or to remove scar tissue. An instrument is attached to a camera that is indeed inserted through a small incision under one’s navel. The cavity is also inflated with a small amount of carbon dioxide in order to make visualization easier.

The operating microscope does provide excellent visualization of the uterus, ovaries as well as fallopian tubes, and also improves the ability to detect any scar tissue or endometriosis.

Additional instruments are indeed placed through small incisions just above the pubic hairline and these instruments do allow the operator to grasp or incise. The incision is closed with several stitches.

The most common side effects that one experiences are a sore throat, shoulder pain, abdominal bloating and general stiffness. These side effects do get usually resolved in one to two days. Normal activities and work can be resumed shortly after the procedure.

Operative Laparoscopy

Operative laparoscopy is made used to treat ectopic pregnancies, ovarian cysts and tumors, endometriosis and pelvic adhesions. When made use of properly, operative laparoscopy does offer numerous advantages. The surgeon can also avoid an open abdominal incision, thus allowing an outpatient procedure. It also does minimize discomfort and also visible surgical scars. Most important is the fact that the laparoscopic approach often does produce better results than other types of surgery. This is also probably due to decreased tissue trauma and also lessened adhesion formation.

Diagnostic or Operative Hysteroscopy

Hysteroscopy is indeed a procedure that does allow a visual examination of the interior of one’s uterus and is also often performed at the time of laparoscopy. This procedure is done by inserting a long, slender instrument directly into one’s uterus via the cervix. The diagnostic procedure does usually take a few minutes.

If intrauterine lesions such as myomas, polyps or scar tissue are found, then the doctor can also perform an operative hysteroscopy. This is done by placing small instruments through the operative port, which enables the doctor to remove or even re-sect abnormal tissue. When extensive lesions are found in the uterine cavity, it may be necessary to place a catheter in the cavity for a few days in order to lessen the development of scar tissue.

Myomectomy

Myomectomy happens to be a surgical procedure in which fibroids or myomas are removed from one’s uterus. Myomas are the most common tumors that are found in the female genital tract. They are also estimated to occur in 20 and 50 percent of women in their later reproductive years. Not all myomas do need to be removed. Patients with no symptoms who would like to get pregnant could also attempt conception for six to 12 months. Some myomas cause irregular bleeding, heavy menstrual flow, abdominal distension or other symptoms. Symptomatic women who do want to conceive should consider surgery.

For myomas located only in one’s uterine cavity, a hysteroscopic approach is indeed performed. For myomas located in one’s muscle, an open approach (abdominal myomectomy) is often recommended for patients who are wishing to become pregnant. This operation is no doubt traditionally done through a laparotomy via a “bikini” or transverse incision. As in the case of all surgeries, there are certain risks related to laparoscopic myomectomy, which need to be discussed thoroughly with one’s doctor.

Tubal Cannulation

Tubal cannulation is made use of in order to help clear a blockage in the fallopian tubes. The procedure is indeed done by guiding a catheter through the fallopian tube. Tools do help remove the blockage which is guided through the catheter. Tubal cannulation is often done at the same time as a hysterosalpingogram when the dye is made use to determine any blockages in the fallopian tubes.

Reversal of Sterilization / Microsurgical Tubal Reanastomosis

Microsurgical tubal re-anastomosis is acknowledged as a procedure used to reverse tubal sterilization. It is traditionally performed through a mini-laparotomy incision or “bikini-cut” and is also an operating microscope. Many variables affect the success rates of tubal reanastomosis, which include health, the age of the female and time interval from sterilization to anastomosis.

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