Laparoscopy is a minimally invasive technique which allows our fertility specialists to inspect (diagnostic laparoscopy) and perform surgical procedures on (operative laparoscopy) the uterus, fallopian tubes, and ovaries.
Depending on the organs we wish to have a look at, a small incision is made inside the belly button, or closer to the upper pubic region. Laparoscopic surgery is also known as keyhole surgery, as the fibreoptic camera on the end of the laparoscope is tiny.
This process allows us to identify any abnormalities which may be preventing women from conceiving, confirm a suspected diagnosis, and/or carry out therapeutic procedures simultaneously.
Laparoscopy is not painful, as it is carried out under general anaesthesia – you will be asleep throughout the entire process. Because the incision and laparoscope are so small, only minor healing is required afterwards, and only barely visible scar tissue results.
This is one of the reasons gynaecological laparoscopy is often referred to as the ‘gold standard’ in evaluating female fertility.
Some of the conditions Wijnland’s laparoscopic surgeons can identify and treat through this procedure include:
- Uterine fibroids
- Ovarian cysts
- Tubal patency
- Polycystic ovaries
- Pelvic adhesions
- Endometriosis
- Structural abnormalities of the uterus
- Sterilisation reversal
Find out more about some of these conditions and how endoscopic surgery can help:
Abdominal Adhesions
Abdominal adhesions are areas where scar tissue has formed inside the body, often between the pelvic organs and abdominal wall. This can occur as a result of abdominal surgery, trauma, or some infections. You may have no detectable symptoms at all, or might experience (sometimes severe) abdominal pain. These abdominal adhesions can also be the underlying cause of infertility.
Laparoscopy can help to confirm and release abdominal adhesions through a process known as abdominal adhesiolysis. Aside from increasing your chances of getting pregnant, abdominal laparoscopy can also remove the bowel pain often associated with abdominal adhesions.
Cystectomy
Laparoscopic surgery for the removal of ovarian cysts or masses offers much faster recovery times compared with open surgery, and is of course far less invasive. It can be used to alleviate the symptoms associated with conditions such as PCOS – Polycystic Ovarian Syndrome – or when cysts are growing and/or have the potential to become cancerous.
The aim is always to help preserve the patient’s fertility. It is important to note, however, that a cystectomy can have an impact on your egg count, so our fertility experts will advise you whether it’s the right choice for your unique situation or not.
Tubal Patency Check
A laparoscopic patency test is used to determine whether the fallopian tubes are blocked or clear (tubal patency). This is often done with the aid of a special dye which is injected through the fallopian tubes.
Caesarean Section Scar Defect
Some women who undergo a Caesarean section when giving birth may suffer damage to and/or thinning of the muscle of the uterus, which makes falling pregnant again difficult. This defect (called a uterine niche or isthmocele) can usually be detected on an ultrasound, and repaired through laparoscopy. This involves removing the defect, and then carefully re-suturing the uterus.
Endometriosis Surgery
Endometriosis is a condition which can affect the ovaries, fallopian tubes, and pelvic tissue, wherein the lining of the uterus (the endometrium) grows outside of the uterine cavity. These implants cause inflammation, and often severe pain as well as menstrual irregularities, and can lead to difficulty getting pregnant.
Laparoscopic endometriosis surgery can be extremely beneficial for women who suffer from endometriosis and wish to conceive, especially when combined with hormone therapy and IVF (in vitro fertilisation). In severe cases which require more extensive surgery, Wijnland’s fertility surgeons will walk you through your options to preserve your chances of having a baby.
Laparoscopic Hysterectomy
A hysterectomy, or complete removal of the uterus, is sometimes necessary due to issues such as a prolapsed uterus, cervical, uterine or ovarian cancer, or pelvic inflammatory disease which is not responding to treatment.
Laparoscopic hysterectomy is currently regarded as the safest and most advanced method to perform a hysterectomy, as your surgeon has a full view of the surrounding organs throughout the procedure. Some additional benefits include fewer complications, less pain and blood loss, and a decreased chance of infection.
Sterilisation Reversal
Also known as a tubal ligation reversal or tubal re-anastomosis, this procedure involves using a laparoscope to perform microsurgery on the fallopian tubes, removing the section blocked during sterilisation and reconnecting them (re-anastomosis).
While this procedure is incredibly advanced, (between 50 to 80% of women who undergo sterilisation reversal go on to have healthy pregnancies) it is important to be aware that it may not always be successful, especially in older women, or when there is not sufficient healthy fallopian tube remaining.