Laparoscopy overview
• Laparoscopy for infertility is a minimally invasive surgical procedure in which a telescope-like instrument (laparoscope) with light and small camera allows the surgeon to examine the pelvic anatomy for causes of female infertility.
• Laparoscopy can be diagnostic, assessing for causes of infertility in the uterus, fallopian tubes and ovaries.
• An operative laparoscopy involves surgical treatment for problems found during a diagnostic laparoscopy procedure, utilizing small surgical tools passed through the laparoscope.
• Laparoscopic surgery can also be used to remove scar tissue or endometriosis.
When is laparoscopy used for treating infertility?
Laparoscopy for infertility is generally only performed after other fertility tests have not resulted in a conclusive diagnosis. For this reason, laparoscopy is often performed on women with unexplained infertility.
Laparoscopy also allows for biopsy of suspect growths and cysts that may be hampering fertility. Laparoscopy may be recommended for women experiencing pelvic pain, which is a potential symptom of endometriosis. Laparoscopy can also remove scar tissue that can be a cause of pelvic or abdominal pain.
Why It’s Needed
Some causes of infertility can only be diagnosed through laparoscopy.
(Endometriosis, for example.) Laparoscopy allows your doctor to not only see what’s inside your abdomen but also biopsy suspicious growths or cysts.
Also, laparoscopic surgery can treat some causes of infertility, allowing you a better chance at getting pregnant either naturally or with fertility treatments.
How Is It Done?
Laparoscopy is performed in a hospital under general anesthesia. While it is sometimes possible to conduct a diagnostic laparoscopy in a fertility clinic office, this is not recommended. In the office setting, if something is found during the procedure, you will need to have the procedure again in a hospital setting for the repair.
Your doctor will give you instructions on how to prepare for surgery beforehand. You will probably be told not to eat or drink for 8 or more hours before your scheduled surgery, and you may be instructed to take antibiotics.
When you get to the hospital, you’ll receive an IV, through which fluids and medication to help you relax will be delivered. The anesthesiologist will place a mask over your face, and after breathing a sweet-smelling gas for a few minutes, you’ll fall asleep.
Once the anesthesia has taken effect, the doctor will make a small cut around your belly button. Through this cut, a needle will be used to fill your abdomen with carbon dioxide gas. This provides room for your doctor to see the organs and move the surgical instruments.
Once your abdomen is filled with gas, the surgeon will then place the laparoscope through the cut to look around at your pelvic organs. The surgeon may also biopsy tissue for testing.
The surgeon will visually evaluate the pelvic organs and the surrounding abdominal organs. He or she will look for the presence of cysts, fibroids, scar tissue or adhesions, and endometrial growths. He or she will also look at the shape, color, and size of the reproductive organs.
A dye may be injected through the cervix, so the surgeon can evaluate if the fallopian tubes are open.
Even if no signs of endometriosis or other problems are found, the surgeon may remove a sample of tissue to be tested. Sometimes, very mild endometriosis is microscopic and cannot be seen by the naked eye with the laparoscopic camera.
If an ectopic pregnancy is suspected, the surgeon will evaluate the fallopian tubes for abnormal pregnancy.
How Will It Feel?
During laparoscopic surgery, you’ll be under the effects of general anesthesia, so you should not feel any pain, nor remember the procedure.
When you wake up, you may have a sore throat. This is caused by the tube placed down your throat to help you breathe during surgery. (This tube is removed before you wake-up).
It’s normal for the area around the cuts to feel sore, and your abdomen may feel tender, especially if your doctor removes a lot of scar tissue. You may feel bloated from the carbon dioxide gas, and you may experience sharp pains in your shoulder. This should go away in a few days.
Dr. Ruchi Tandon is a reputed Gynecologist practicing in leading hospitals in South Delhi namely Max and Apollo hospitals with over 14 years of experience in handling all kinds of Gynecological conditions including infertility.