Laparoscopic and Hysteroscopic Surgery
Equipped with all essential and complementary equipments to conduct most of the Gynecology endoscopic operations especially in the field of infertility, such as adhesiolysis, opening the uterus tubes, endometriosis treatment, uterus cysts removal, ectopic pregnancy, and Uterine fibroids …etc.
In addition to assisting in ART procedures such as:
- Zygote intrafallopian transfer (ZIFT)
- Gamete Intra-Fallopian Transfer (GIFT)
- Tubal Embryo Transfer (TET)
What is laparoscopy?
Laparoscopy is a surgical procedure that involves insertion of a narrow telescope-like instrument through a small incision in the belly button. This allows visualization of the abdominal and pelvic organs including the area of the uterus, fallopian tubes and ovaries.
What is laparoscopy used for in women with infertility?
This procedure allows us to determine whether there are any defects such as scar tissue, endometriosis, fibroid tumors and other abnormalities of the uterus, fallopian tubes and ovaries.
If any defects are found then they can sometimes be corrected with operative laparoscopy which involves placing instruments through ports in the scope and through additional, narrow (5 mm) ports which are usually inserted at the top of the pubic hair line in the lower abdomen.
Because of the cost and invasive nature of laparoscopy it should not be the first test in the couples diagnostic evaluation. In general, semen analysis, hysterosalpingogram, assessment of ovarian reserve and documentation of ovulation should be assessed prior to consideration of laparoscopy. For example, if the woman has a clear ovulation problem or her male partner has a severe sperm defect then it is unlikely that laparoscopy will provide additional useful information that will help them conceive.
Laparoscopy was part of the standard female infertility work-up until the mid 1990's. Before then most Reproductive Endocrinology and Infertility specialists did laparoscopy prior to using gonadotropins for superovulation of the ovaries as a fertility treatment. However, this tradition has been challenged as being of questionable benefit when assessed by its cost-effectiveness and invasiveness.
Fertility clinics are doing far less diagnostic laparoscopy today than in the 1980's and 1990's. Much of this is due to the major advances in IVF technologies and the resulting increases in IVF success rates . Couples are carefully considering the costs of fertility treatments for women. They are asking for insemination treatments and in vitro fertilization , but are usually not interested in having diagnostic surgery.
Hysteroscopic Surgery
Hysteroscopy is a procedure that involves insertion of a narrow telescope-like instrument through the vagina and cervix into the cavity of the uterus (endometrial cavity). The uterine cavity is then distended with fluid and visualized.
This procedure allows us to see if there are any uterine cavity defects such as:
- Fibroid tumors
- Endometrial polyps
- Intrauterine scar tissue
- septate uterine malformation
- Other uterine problems
If any defects are found then they should be corrected with operative hysteroscopy which involves placing instruments through ports in the scope that allow us to cut, cauterize, etc. to correct the problem.
Is it a big procedure? How much work would I miss?
Hysteroscopy is an out-patient procedure that is usually done in a hospital but can also be done in the office. The actual procedure (diagnostic) usually takes 2-5 minutes.
No anesthesia at all is needed for most cases of diagnostic hysteroscopy if a microhysteroscope (scope diameter less than 5mm) is used.
General anesthesia or local anesthesia can be used if any operative work is required.
Usually the woman is discharged home approximately 15-30 minutes after the procedure. She can return to work the next morning if general anesthesia was used, or immediately if no anesthesia (or local) was used. Mild pain and cramping is common after operative hysteroscopy, but it usually is brief (lasting perhaps 30 minutes, possibly up to 8 hours). Hysteroscopy
Hysteroscopy is a procedure that involves insertion of a narrow telescope-like instrument through the vagina and cervix into the cavity of the uterus (endometrial cavity). The uterine cavity is then distended with fluid and visualized.
This procedure allows us to see if there are any uterine cavity defects such as:
- Fibroid tumors
- Endometrial polyps
- Intrauterine scar tissue
- A bicornuate uterus or septate uterine malformation
- Other uterine problems
If any defects are found then they should be corrected with operative hysteroscopy which involves placing instruments through ports in the scope that allow us to cut, cauterize, etc. to correct the problem.
What problems can defects of the uterine cavity cause?
Abnormalities of the endometrial cavity can be responsible for infertility or problems with recurrent miscarriage.
Hysteroscopy and other methods, such as a hysterosalpingogram, ultrasound, or ultrasound with saline test are useful in diagnosing and correcting these defects.
Complications
Complications associated with hysteroscopy include the possibility of infection, uterine perforation, vaginal bleeding, and fluid overload.
