Diagnostic & Operative Laparoscopy

What is Laparoscopy?

Laparoscopy, also known as "keyhole surgery," is a minimally invasive surgical procedure that allows a doctor to look directly at the outside of the uterus, fallopian tubes, and ovaries. It is a critical tool in the field of reproductive medicine, used for both diagnosing the cause of infertility and treating specific conditions that may be preventing conception.

Unlike traditional open surgery that requires a large incision, laparoscopy is performed through one or more small incisions (usually 0.5–1 cm) in the abdomen. A thin tube with a camera (laparoscope) is inserted, providing high-definition images of the pelvic organs on a monitor.

Why is Laparoscopy Performed in Fertility?

Laparoscopy is often recommended when other non-invasive tests (like ultrasound or HSG) do not provide a clear answer, or when symptoms suggest a condition that needs surgical correction. It is used to:

• Diagnose Endometriosis: Laparoscopy is the "gold standard" for diagnosing endometriosis, a condition where uterine-like tissue grows outside the uterus, causing scarring and infertility.
• Check Fallopian Tubes: We can perform a "chromopertubation" where dye is injected through the cervix to see if it flows freely through the tubes, confirming they are open.
• Remove Adhesions: Scar tissue from previous infections or surgeries can bind organs together; laparoscopy allows for the delicate removal of these adhesions (adhesiolysis).
• Treat Ovarian Cysts: Cysts like endometriomas (chocolate cysts) can be removed to improve ovarian function.
• Remove Fibroids: Subserosal or intramural fibroids that may be affecting fertility can be removed (myomectomy).
• PCOS Management: In some cases, "ovulation drilling" is performed to help regulate hormonal balance in women with PCOS.

The Laparoscopy Procedure: What to Expect

1. Preparation

The procedure is typically performed under general anesthesia. You will be asked to fast (no food or water) for several hours before the surgery.

2. The Surgery

The surgeon makes a small incision near the navel. Carbon dioxide gas is used to gently inflate the abdomen, providing a clear view of the organs. The laparoscope is inserted, and if treatment is needed, additional small incisions may be made for other surgical instruments.

3. Recovery

Most patients go home the same day (day-care procedure). You may feel some bloating or shoulder pain from the gas used, but this usually subsides within 24–48 hours. Most women can return to normal activities within a week.

Advantages of Laparoscopy