Sunday, 10 August 2014

Laparoscopy for infertility treatment

                                    
  

Laparoscopy,which is also known as keyhole surgery or minimally invasive Surgery  is the surgical method, in which a small camera is passed through the umbilicus to visualize  the internal organs on a monitor. The surgeon can  perform even complicated surgeries like removal of uterus  easily through this procedure.


Advantages

1.     No hospital admission is required.
2.     Wound is small and less than 1cm.
3.     No need for rest.
4.     Precise surgery.
5.     Minimal blood loss.
6.     Short surgery.
7.     Surgery can be recorded and viewed later.
8.     Enlarged and clear view compared to open surgery.
9.   Cost is comparatively less, when the loss of job and loss of work at home is taken into account.
10.Excellent treatment for infertility,  especially for checking tubes and ovarian drilling in PCOS.
11.Infections are much lesser compared to open surgery and are easily treatable.
12.Easier for surgeons, especially for obese patients as laparotomy is difficult in such cases.
13.Risk in diabetics patients is minimal.
14.Less chance for thrombosis (blood clotting)
15.Hysteroscopy gives good vision of uterine cavity and it is possible to remove polyp, fibroid or correct septum.
16.No weight gain risk,  as patient do not need rest post operation.  
17.Risk of post op adhesions less.
18.Laparoscopy can be repeated any number of times as the cut is very small.
19.Risk of injury to viscera is also minimal.



If pregnancy cannot be achieved even after 3-6 months of treatment, ideally laparoscopy should be done. Taking medicines blindly is bad for the body, as it may increase risk of cancer in future. The skill of surgeon is very important in laparoscopy  for getting a good result.

Common surgeries:

Diagnostic Hysterolaparoscopy
Done to evaluate the inside and outside of uterus, B/L tubes, ovaries and pelvis. Tubes can be checked for block and infection in vagina, cervix, and pelvis can also be detected.

Laparoscopy  & ovarian drilling
This is very effective in PCOS for getting rid of old follicles and stimulating the ovulation process.   

Laparoscopy tubal/ Fimbrial cystectomy
Small cysts in tubes make them ineffective in picking up the egg after ovulation, even if the tubes are open. The surgery is very effective to rectify this problem.

Laparoscopy &  ovarian cystectomy
Different types of cysts which are formed in the ovaries can be managed by laparoscopy.

Laparoscopy  & cauterization of endometriosis
Endometriosis causes block in tubes, adhesions, stops ovulation and can cause pain. This surgery needs good skill and high precision and is very effective in infertility cases.

Laparoscopy for ectopic pregnancy
Pregnancy occurring outside uterus can be removed by this method.

Laparoscopic myomectomy
Fibroids are benign tumors of uterus and can be removed if they affect fertility or if they are symptomatic.

Diagnostic hysteroscopy
Is conducted to check if the cavity is normal in size, shape and if tubal opening is clear.

 Laparoscopic varicocelectomy  
 is done for men with complaints of varicocele.

Other laparoscopic surgeries include laparoscopic hysterectomy, laparoscopic appendectomy, laparoscopic cholecystectomy, Hysteroscopic polypectomy,       hysteroscopic septal division, hysteroscopic tubal cannulation etc. 



Dr.Anita Mani
anitadane@gmail.com
Infertility& Surrogacy Specialist at Gift IVF Centre

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