Diagnostic Laparoscopy
Diagnostic laparoscopy is a minimally invasive surgical procedure in which a telescope-like instrument (laparoscope) with light and a small camera is used. It is passed through minimal incisions on the abdomen to examine the pelvic anatomy for causes of female infertility.
In addition to assessing the tubes, laparoscopy can also examine other organs of the pelvis including the uterus (womb), ovaries, and their surrounding structures.
This procedure is beneficial to infertile couples especially when marital life is long or when there is unexplained infertility and previous failed IVF cycles. For this group, detecting peritoneal endometriosis, adhesions, and tubal issues is relevant.
Diagnostic laparoscopy:
Laparoscopy is a type of surgical procedure that allows a surgeon to access the inside of the abdomen (tummy) and pelvis without having to make large incisions in the skin.
How is a laparoscopy performed?
A laparoscopy is a diagnostic procedure. A surgeon uses a thin device with an attached light and camera to help them more clearly visualize organ damage and disease. During a laparoscopy, patient lie in a lithotomy position. Laparoscopic surgery is performed under general anaesthesia and patient will be asleep.
Laparoscope will be inserted into the abdomen through a small incision. At each port a tubular instrument known as a trocar is inserted. Specialized instruments and a special camera known as a laparoscope are passed through the trocar.
This system allows the surgeon to perform the same operations as traditional surgery but with smaller incisions during the procedure. At the beginning of the procedure, the abdomen is inflated with carbon dioxide gas to provide a working and viewing space for the surgeon. The laparoscope transmits images from the abdominal cavity to high-resolution video monitors in the operating room. This system allows the surgeon to perform the same operations as traditional surgery but with smaller incisions.
We might also make a second incision at the pubic hairline. This incision provides an additional opening for instruments needed for completing minor surgical procedures. To carry out a laparoscopy we might also use a uterine manipulator to be inserted into the vagina, cervix, and uterus to allow for pelvic organ movement to see different pelvic anatomy. The cuts will be closed with stitches, tape, or surgical staples. A sterile bandage or dressing or adhesive strips will be applied.
What happens after a laparoscopy?
The patient must wait until the anesthesia has worn off before we can ensure they are not experiencing any side effects from the procedure. They will need to remain in the hospital overnight following the procedure. In the days after the laparoscopy, the patient will undergo recovery.
Potential complications include:
Commonly, patients may experience shoulder pain following the procedure, often due to the carbon dioxide gas used to expand the abdomen and provide space for the surgical instruments. This expansion can irritate the diaphragm, which shares nerves with the shoulder, causing discomfort.
- • Damage to adjacent organs and blood vessels.
- • Bleeding.
- • Anaesthesia-related issues.
- • Infection.
- • Inflammation of the abdominal wall.
- • Formation of a blood clot that could migrate to the legs, pelvis, or lungs, leading to clotting issues.
- • Although extremely rare, there is a possibility of a blood clot traveling to the heart or brain, potentially causing a heart attack or stroke.
Advantages
Adopting this approach offers multiple benefits over conventional surgery due to the minimal incisions involved.
• The scars are smaller.
• Hospital stays are shorter.
• There is reduced pain during the healing of scars, which also heal faster.
• Recovery time is quicker, allowing for a faster return to daily activities.
• There is potentially less scarring inside the body.