Conditions that affect the woman’s reproductive functions cannot always be diagnosed by history and physical examination alone. Other diagnostic tests including ultrasound, sonohysterogram or hysteroscopy (x-rays) may not provide the answer. In these cases, diagnostic surgeries such as laparoscopy and/or hysteroscopy can be helpful in providing information about infertility and other common gynecological disorders such as endometriosis, pelvic adhesions, abnormal bleeding, or pelvic pain. Diagnostic laparoscopy is used to view the outside of the uterus, ovaries, fallopian tubes, and internal pelvic area. Diagnostic hysteroscopy is used to view the inside of the uterus.
What is Laparoscopy?
Most laparoscopies are performed in a day surgical center. The procedure is performed with a slender instrument called a laparoscope. The laparoscope is inserted through a small cut inside the navel. Carbon dioxide gas is introduced into the abdominal-pelvic cavity so that visualization of the pelvic organs is possible. The laparoscope has a small camera and light source on the end to allow the physician to see inside. Usually, a second instrument such as a probe is inserted through a second small incision just above the pubic bone. The probe helps the physician to gently move the pelvic organs for better visualization.
The surgery is generally completed in about one hour, and the instruments and laparoscope are removed. The carbon dioxide gas is allowed to escape and the small incisions are repaired with sutures. The patient is awakened from general anesthesia, then monitored in the recovery room and later discharged home on the same day.
Reasons for Laparoscopy
• Dysmenorrhea (painful menses0
• Dyspareunia (painful sexual intercourse)
• Endometriosis treatment
• Fimbrioplasty (repair of fallopian tubes)
• Neosalpingostomy (open fallopian tubes)
• Ovarian cystectomy (remove cysts)
• Ovarian drilling
• Pelvic adhesions treatment
• Pelvic pain.
• Removal of scar tissue
• Unexplained infertility
What are the Risks of Surgery?
Complications from these procedures are rare and seldom serious. Infections are possible and my require antibiotics before and/or after surgery. However, injury to the bladder, bowel, uterus or blood vessels is possible and should be discussed thoroughly with your doctor. In case of injury, a laparotomy (open surgery) may be required. Patient with previous multiple abdominal surgeries (especially bowel surgery), severe obesity, or a history of pelvic adhesions may have increased risks.
How do I Schedule a Laparoscopy or Hysteroscopy
If you have not done so already, make an appointment to discuss the procedure with your doctor thoroughly. A short office visit, just before the surgery, may be necessary to complete a pre-operative evaluation and review the consent forms.