Laparoscopy is a surgical discipline which primarily involves the doctor making 1 – 3 small cuts (or incisions) on the body through which a laparoscopic tube is inserted. A laparoscopic tube is a surgical instrument fitted with a light and a camera. Laparoscopy typically helps reduce post-operative pain and reduces the risks of open surgery. That being said, the use of laparoscopy for infertility in women is still a topic of debate as those with pelvic pain may be required to undergo surgery. While an ovarian drilling is the most commonly performed operative procedure, a myomectomy will help in the removal of fibroids from the uterus. In addition to pelvic pain and irregular or heavy periods, these fibroids can also cause blockages in the uterus that can make it more difficult for the woman to conceive.
When is Laparoscopy recommended?
A healthcare professional may suggest to opt for laparoscopic surgery for infertility only after infertility has been tested, and furthermore, if the symptoms warrant it. The conditions for which laparoscopy treatment may be recommended include:
- Menstrual cramps / pelvic pain
- Suspected endometriosis
- Any inflammatory disease / pelvic adhesions
- Suspected hydrosalpinx: This is a case of a blocked fallopian tube that hinders IVF success rates.
- Endometrial deposits that are detrimental to fertility
- Suspected ovarian cyst that may / may not cause pain and / or distortion in the uterine cavity.
- Fibroids that cause pain
Why is it important?
Although the use of laparoscopy treatment on women for infertility is still a topic under debate, there are certain cases of infertility where laparoscopy is the only viable surgical method as it allows the doctor to see the inside of the abdomen and diagnose any suspicious growth of cysts. Laparoscopy can also be employed to eliminate any scar tissue, fibroid, and / or endometrial deposits.
How is it done?
Laparoscopic surgery requires a hospital environment while employing the use of general anaesthesia. A laparoscopic surgery can be conducted inside a fertility clinic, however, it is not recommended as it requires trained and seasoned professionals who can guide the patient on the necessary preparations. The patient might be advised to avoid eating and drinking at least 6-8 hours prior to the laparoscopy surgery and might even be instructed to take antibiotics during that period.
The anaesthesiologist will place a mask over your face, and after breathing a sweet-smelling gas for a few minutes, you’ll fall asleep. Once the anaesthesia 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 in the right directions.
Once the abdomen is sufficiently filled with gas, the doctor will then insert the tube through the incision made to analyse the pelvic organs. The surgeon may also employ a biopsy for testing. It all starts with the surgeon visually examining the pelvic organs and the surrounding abdominal organs for any presence of cysts, scar tissues, adhesions, fibroids, and / or endometrial growths. A dye can be injected through the cervix, so the surgeon can evaluate if the fallopian tubes are open.
If ectopic pregnancy is suspected, the surgeon will evaluate the fallopian tubes for an abnormal pregnancy.
Post-operative scenario:
- The patient, during the surgery, will be under the effect of anaesthesia and will not feel any pain
- The patient may / may not wake up with a sore throat
- The area around the incisions may feel sore which is completely normal
- The patient may also feel bloated due to the excess of CO2 gas inside
- It will take you 2-3 days to recover from the strenuous effect of the laparoscopy treatment and you can resume most of your activities in 2-3 days’ time depending on nature of the surgery.
- The doctor may prescribe additional medicines and antibiotics to help you recover from the effects of minimally invasive laparoscopic surgery
