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Laparoscopy In Infertility & Gynaecology

Laparoscopy In Infertility & Gynaecology

Laparoscopy is a minimally invasive surgical technique where small cuts are made on the abdomen and then it is distended with gas. Then the laparoscope, a long, thin tube with a high-intensity light and a high-resolution camera at the front is inserted through an incision in the abdominal wall. As the Laparoscope moves along, the camera relays images to a video monitor. This in turn allows the surgeon to see inside the abdomen to evaluate the uterus, tubes and ovaries real time and perform the needed surgery with ease.

The main advantage of Laparoscopic Surgery or Key Hole Surgery Treatment is that it ensures quicker recovery and facilitates early discharge from the hospital. In addition, it is also less painful and ensures lesser adhesions (scar tissue) in the abdomen.

At our center, we have the requisite preoperative, operative and postoperative support and care for ensuring the best of laparoscopic surgery in Hyderabad. Apart from this, the laparoscopic surgeons are skillful and can handle even the most advanced laparoscopic surgical techniques while providing the highest level of quality care for laparoscopic surgery.

Diagnostic Laparoscopy

In the evaluation of infertility, laparoscopy is the gold standard in the determination of fallopian tubes status and the presence of medical problems in the pelvis, which might inhibit ovulation, egg transport and fertilization.

The tubal patency is assessed by the instillation of dye through the cervical canal and visualization of the dye entering the pelvic cavity from the fallopian tubes. Laparoscopy also allows the assessment of peritoneal surfaces (looking for endometriosis), tubo-ovarian architecture and the external assessment of the uterus. Laparoscopy can also be used to assess pelvic masses or other adnexal pathology including the rare cases of reproductive tract anomalies. These minimally invasive surgeries help to improve fertility in subfertile couples.

Operative Laparoscopy

Ectopic Pregnancy

The more conservative approach is salpingostomy, which involves an incision of the tube and removal of the ectopic, has been shown to maintain tubal patency. In cases when tube is ruptured or damaged salpingectomy (removal of affected tube with ectopic pregnancy) is the best option and life saving.

At our centre we use world-class equipment for hysteroscopy. We run a training program for gynaecologists in the art of hysteroscopy and have international and national guest faculty as well.

Endometriosis

Laparoscopy can be done for both diagnosis and treatment. The surgical treatment ranges from diathermic cautery to the specific peritoneal deposits through to radical excision of the peritoneum with of the endometritic areas. Surgery has been shown to improve fertility in mild and moderate endometriosis. In cases of severe endometriosis, there are ‘chocolate cysts’ or endometriomas in the ovaries, which sometimes need to be removed.

Tubal Disease

In cases tubal disease, laparoscopy can be done to treat severe adhesions, hydrosalpinx and other tubal pathology.

Myomectomy

Myomas (fibroids) can be located on the outer surface of the uterus (pedunculated), under the peritoneal surface on the outside of the uterus (subserosal), within the uterine wall (intramural) and internally underlying the endometrium (submucosal). The last can also form polyps in the uterine cavity. The first three types can be easily removed by laparoscopy, thus increasing the chances of pregnancy.

Ovarian cysts and PCOS

Laparoscopy can be done to remove large ovarian cysts. In cases of PCOS, ovarian drilling is done to enhance the chances of pregnancy.

Laparoscopic hysterectomy

Laparoscopic hysterectomy has shorter recovery time, which has implications to the health and lifestyle of the patient and the costs to the health care system. A clinical advantage of laparoscopic procedures over the vaginal approach is that one can easily access the ovaries if an oophorectomy is planned with the hysterectomy.

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