In gynecological terms, laparoscopy surgery involves a medical procedure where the doctors are able to see the reproductive organs of a woman. This is done with the help of a laparoscope which is a thin, long tube very similar to a telescope. The laparoscope is fitted with a lens with a camera and light at one end attached to it and it is inserted to the neck of the womb.
As laparoscopy surgery is a technique that is minimally invasive, involving just small cuts, depending on the need, it may be just a single cut, two or if need be three cuts in the abdomen through which the laparoscope is inserted to the neck of the womb. General anesthesia is administered so that the muscles can relax and also due to the presence of pneumoperitoneum, which is integral to laparoscopic surgery, there could be respiratory changes.
This diagnostic gynecological process involves distending the abdomen with gas and then inserting the laparoscope to view female reproductive organs, like the Fallopian tubes, uterus, and ovaries and the image is relayed on a television monitor. At the end of the procedure, carbon dioxide is let out and the incisions or cuts sutured-up and dressing are done. This whole process usually takes around 30 – 60 minutes, with the time duration extending, when the surgeon is treating a condition and the kind of surgery being done.
Ø What should be done prior to surgery?
Subject to the kind of laparoscopic surgery being done, doctors advise that the person undergoing the treatment should not eat or drink anything six to twelve hours prior to the procedure.
As it is a fairly simple procedure that is minimally invasive, most people could leave the hospital on the very same day or at the max the following day. It is advised to arrange for someone to drive you, as it is not recommended to drive for at least 24 hours after the procedure.
Ø When is laparoscopy surgery done?
Doctors usually recommend this medical procedure to be performed to help diagnose and understand the cause of infertility. Normally, it is performed only after the basic evaluation of female infertility causes in each case has been done. This basic infertility evaluation includes checking to see if ovulation is happening. Analysis of the Fallopian tubes for blockages, ovarian reserve, ultrasound for the women, and semen analysis for the men.
The other reason when laparoscopic surgery is performed is when there is a possibility of endometriosis, pain during coitus, extreme pelvic pain, or cramps during the menstruation cycle. In case the doctor feels there is an ectopic pregnancy, could prove to be dangerous if not addressed timely.
If there is any minor abnormality the problem area is treated on the spot in consultation or by the female infertility specialist by either removing or repairing the problem area.
Female infertility issues that can be treated through laparoscopic surgery include treatment of the ovary, treating the scarring around the tube area and ovaries, and sometimes removal of the fibroid. Included but not restricted to the following issues that can be treated
- Possibility of endometrial deposits reducing fertility, requiring female infertility treatment consultation. Some women with endometriosis complain of lower abdominal pain, pain during the menstrual cycle or pain during coitus, and on the other end of the spectrum are women who have no symptoms at all. But endometriosis is a very common cause for infertility.
- For low-grade levels of endometriosis, laparoscopic surgery followed by basic treatment is beneficial. However, for severe endometriosis, IVF is the answer. There is a divided opinion on the treatment, with some Doctors of the opinion that removal is only required in case of severe pain and the others strongly advocating it, as it can improve the success rate of pregnancy.
- Blocked Fallopian tubes medically called Hydrosalpinx. Treatment involves removing the affected tube.
- Tubal repair for a blocked Fallopian tube. The approach for its treatment is not the same for everyone. If IVF is required after surgery, then a better option would be to go for IVF straight away. However, if it is a young woman with no other fertility issues then, this procedure is worth it.
- When a cyst is blocking the Fallopian tubes or causing pain. Then, draining the cysts with the help of a needle guided by ultrasound is beneficial. Large endometrial ovarian cysts may reduce ovarian reserves; doctor consultation is required.
- To treat PCOS ovarian drilling is recommended by the doctor. It involves making very small punctures in the ovaries, sometimes three requiring up to eight. Females with PCOS whose ovulation response to fertility drugs is not encouraging, this process could help them to ovulate on their own. Most doctors are skeptical about it, as it is a risky procedure and the risks involved are higher than the benefits.
Ø How does laparoscopy feel?
During the procedure, people generally experience the same effects as in general anesthesia, so that there is no pain. When people wake up after surgery they may have a sore throat, this happens as the tube is placed down the throat to help facilitate smoother breathing during surgery. It is taken off before they wake up.
The area surrounding the cut may tend to feel sore and the abdomen tender, especially when a lot of scar tissue is taken off. Due to gas, there is a general feeling of being bloated also there could be a sharp pain in the shoulder. All this should settle down in a few days.
Though the patient leaves the hospital the same day of the surgery or the next day, they should be taking it easy for a couple of days. In cases where repairs were done, it may take longer to recover, consult your doctor on what to expect. Patients may be put on pain-relievers and or antibiotics.
What is the way forward for Future Fertility chances?
After the laparoscopic procedure, the doctor will discuss the options to conceive. If you had fibroids removed or a Fallopian tube repaired, you may be able to try to get pregnant without help.
Also, endometriosis treatment or PID, the removal of scar tissue may make it possible to get pregnant without further treatment.
If after a few months after surgery you do not get pregnant on your own, your doctor may recommend fertility treatments
Why is laparoscopy majorly used in the treatment of infertility?
Laparoscopy has transformed the medical field, particularly in the field of surgery, due to the low rates of morbidity and quick recovery. It largely aids female infertility treatment. After this procedure, the doctor would discuss the various options for conceiving. If fibroids, endometriosis, removal of scar tissue have been done, there is a huge possibility to conceive without any further treatment. If pregnancy has still not happened doctor will recommend other fertility treatments.