It is a type of endoscopy in which operations in the abdomen and pelvis is performed through very small incision (0.5 to 1 cm) instead of big incisions in laparotomy. It is also called as minimally invasive surgery. Uterus, fallopian tubes and ovaries can be examined as well as operated by laparoscopy.
Laparoscopy is done under general anaesthesia. Abdominal cavity is inflated with gas for better visualization of the abdominal organs. Laparoscope attached with video camera is inserted through a small incision near umbilicus and other operative instruments are inserted through one or more other small incisions. Video camera helps in getting enlarged view as well as record the procedure. After the surgery finishes gas removed and abdomen deflated and incisions closed with sutures.
Uterus, both fallopian tubes and ovaries are examined thoroughly under direct vision to identify the pathology that can lead to infertility or other symptoms. The chromopertubation test for tubal testing can be done by inspecting the flow of blue dye from the abdominal ostium of fallopian tube while injecting the dye from below.
Polycystic ovarian syndrome is a condition associated with anovulation/oligo ovulation leading to irregular scanty menses, infertility, hirsutism and many a times obesity.
Ovarian Drilling includes performing multiple punctures targeting on the ovarian stroma with unipolar coagulation.decreased ovarian stroma might help in resuming ovulation or decrease the dosage of drugs that are needed for ovulation induction.
It is an abnormal collection of fluid or material in ovarian substance.
Laparoscopy can be performed for drainage, removal or biopsy from such cyst. The material removed is routinely sent for Histopathological examination.
Uterine fibroids are the benign tumour of the uterus which can cause pain during menses, excessive menstruation, infertility or other symptoms pressure symptoms on bowel or urinary tract or other abdominal structures.
Fibroids can be dissected and enucleated using laparoscopy followed by its removal by morcellation and suturing of dead space under laparoscopic guidance.
It is a condition in which pregnancy occurs outside the uterine cavity, mainly in the fallopian tube. This can be confirmed and treated by Laparoscopy by Linear Salpingotom ( where fallopian tube is preserved) or by salpingectomy (where the fallopian tube is removed) provided the patient is hemodynamically stable enough to receive the general anesthesia for laparoscopy.
Sometimes pelvic organs are abnormally adherent to each other or bowel secondary to infection , surgery or endometriosis causing pain or infertility. It is performed using hydrodissection, scissor or laser, atraumatic forceps and harmonic scalpel.
It is an abnormal dilatation of fallopian tube with clear fluid collection in cases of distal tubal block.
Neosalpingostomy or fimbrioplasty can be performed by giving linear /cruciate surgical incision on this blocked distal part and creation of new healthy opening with dissection and monopolar energy under Laparoscopic guidance.
If patient is undergoing IVF, it is advisable to remove or clip the hydrosalpinx for better results.
It is a condition characterised by presence of endometrial tissue outside the endometrial cavity of uterus. During each menstrual cycle, it bleeds with the shedding of endometrial linings causing accumulation of old blood (chocolate colored fluid) in the ovarian tissue leading to chocolate cyst formation, peritoneal scarring leading to appearance of powder puff burns and adhesions of pelvic organs to each other and bowel distorting its relationship. Its presence in uterine musculature leads to adenomyosis. It is also responsible for dysmenorrhoea, menorrhagia and dyspareunia of varying severity. It may also leads to chronic pelvic pain.
These lesions can be diagnosed and treated laparoscopically by cutting or fulguration of endometrial implants. Chocolate cysts can be drained followed by cyst wall removal or fulguration of cyst wall under laparoscopic guidance. Even lesions of rectovaginal endometriosis can be treated laparoscopically under expert hands.
The operation of surgical removal of uterus which is known as hysterectomy can also be performed laparoscopically. It can be performed for various indications including menorrhagia, dysmenorrhoea, Pelvic inflammatory disease, adenomyosis, uterine fibroids and other benign and malignant conditions.
Abnormally blocked tubes or tubes with previous tubal ligation can be opened using microlaparoscopy known as Laparoscopic Tubal Recanalisation or Tubotubal Anastomosis
Dr. Nimisha is an experienced Obstetrician & Gynecologist, working as a fulltime Infertility and IVF specialist since last 5 years. Dr. Nimisha is M.B.B.S. and M.D. (Obstetrics & Gynecology) from B.J. Medical College & civil hospital, Ahmedabad. Dr. Nimisha is also Diplomate of National Board (DNB) and cleared MRCOG part one. After completing her post-graduation, she dedicated herself in treating the couples suffering from infertility. She was involved in handling more than 1000 successful IVF cases. Dr. Nimisha has performed more than 300 Ovum pick up and more than 150 Embryo transfer procedure & 20 surrogacy cases. Dr. Nimisha visited various countries viz. Kenya, Ghana, Tanzania, Uganda and UAE for infertility and IVF. She also holds practicing license in Kenya and regularly performs procedures over there.
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