Laparoscopy
What is Laparoscopy?
Laparoscopy is minimally invasive surgery or keyhole surgery, that allows to access and operate on the pelvic organs through small incisions in the abdomen. It is performed using a laparoscope, a long, thin tube with a high-resolution camera attached to one end. It will be done under general anesthesia.
- Diagnostic Laparoscopy – It is done to identify the cause of unexplained abdominal pain, pelvic pain, or infertility – any presence of ovarian cyst, to check tubal opening, fluid in fallopian tube problems, fibroids, adhesions etc.
- Operative Hysteroscopy – It is done to correct the problem – ovarian drilling for PCOS, ovarian cyst or fibroid removal, cutting of adhesions, tube opening procedure etc.
How does Laparoscopy help in Tubal Block?
Once there is a Tubal block, the laparoscopy helps in evaluating it. At laparoscopy, there can be three scenarios, either the tubes are completely patent, some minor blocks of blood clot or mucus which can be easily cleared or there is a very bad blockage because of adhesions -a fallout of chronic pelvic infection. In the first instance, natural conception with medicines or IUI can be tried, in the second instance, we may need to move forward directly to IVF without wasting further time. Sometimes we see a scenario in between ie, when there is a minor to moderate adhesion which can be corrected during the laparoscopy. In these circumstances again natural conception or IUI may be tried for a few months depending on age, duration, egg and sperm quality.
What are the precautions before Laparoscopy?
- Require basic blood investigations
- Need to come fasting (for 10 to 12 hours)
- Continue some medicines – thyroid, blood pressure medicine after consulting doctor on the day of surgery
What is the procedure of Laparoscopy?
- Done under general anesthesia
- Procedure time – 30 min (Diagnostic) and 45 to 120 min (Operative)
- 3 to 4 small incisions/cut (0.5 to 1 cm) on abdomen
- Carbon dioxide gas is pumped to create space and improve visibility
- Laparoscope is inserted through one of the cuts which is connected to camera and attached to monitor
- Performing the operative procedure if required in the same sitting
- Usually a day care procedure
What are instructions after Laparoscopy?
- Day care procedure – Discharged after 4 to 6 hours of procedure
- Eat light food post procedure on same day
- May observe mild abdominal cramping, nausea, bloated feeling, pain in shoulder tip on same day
- Avoid intercourse for at least two weeks
What are advantages of Laparoscopy in fertility management?
- Diagnostic and operative procedures can be done together
- Significant Fertility enhancing procedure
- Improved visualization
- Reduced scarring
- Faster recovery
- Short hospital stay
- Can resume normal activities in 2 to 3 days time
