Laparoscopy and hysteroscopy are two of the most common procedures to either diagnose a woman’s infertility or correct problems that cause infertility and miscarriage.
Laparoscopy - also known as minimally invasive surgery. It is generally accepted that laparoscopy is the gold standard in diagnosing tubal pathology and other intra ‐ abdominal causes of infertility. The uterus, fallopian tubes and ovaries are located in the pelvis which is at the very bottom of the abdomen. Laparoscopy allows seeing abnormalities that might interfere with a woman's ability to conceive. Most commonly it is used to inspect the pelvic organs (diagnostic laparoscopy), and often to perform surgical procedures (operative laparoscopy) at the same time. The fibre-optic camera on the laparoscope is inserted into the body, through an incision made around the nave, another incision is made near the upper pubic region. Laparoscopy is performed under general anaesthesia.
Laparoscopy is often used for
· Evaluating infertility/Unexplained infertility
· Removing scar tissues or adhesions
· Removing ovarian cysts, fibroids
· Ovarian drilling in PCOS
· Salpingectomy in hydrosalpinx
The benefits of Laparoscopy
· More accurate diagnosis
· No stitches
· Therapeutic benefit in same sitting
· Shorter recovery time
· Fewer post-op complications
· Less scarring
· A hysteroscopy is a procedure used to look at the interior of your uterine cavity. A narrow viewing tool called a hysteroscope is put into the vagina and gently moved through the cervix into the uterus. The hysteroscope has a light and camera hooked to it which is connected to a screen. Fluid is placed into the womb so that the uterus expands. This helps the clinician to view the area better.
Hysteroscopy like laparoscopy can be diagnostic and operative.
Diagnostic hysteroscopy is indicated in
- Repeated IVF failures
- Cervical stenosis to negotiate the cervix
- Diagnose uterine abnormalities like polyps, fibroids, adhesions, uterine anomalies
Operative hysteroscopy is done
- To remove fibroids, polyps, adhesions
- Correct uterine anomalies
- To take guided endometrial biopsies.
Complications in endoscopy are rare when performed under ideal settings and done by expert surgeon.
Bleeding, infection, injury to internal organs etc may occur rarely in laparoscopy.
Perforation, Bleeding, Infection, fluid overload etc may occur during hysteroscopy.