Laparoscopy facts
- Laparoscopy is a minimally invasive surgery that allows us to take a closer look inside the body at the reproductive system to find abnormalities and potentially correct them.
- In a laparoscopy a surgeon makes small incisions in the abdomen and inserts a small fiber optic camera (called a laparoscope) to examine the abdominal/pelvic area, including the exterior uterus, fallopian tubes and ovaries, which the surgeon views on an external monitor.
- Conditions this procedure can diagnose and treat include some of the more common causes of infertility such as blocked fallopian tubes, fibroids and endometriosis.
- With laparoscopy, which is typically done on an outpatient basis, patients recover more quickly and have fewer risks than they do from traditional “open” abdominal surgery.
- Our Dallas IVF physicians may perform these procedures themselves, or if the condition is very advanced, we may recommend one of our colleagues who specialize in reproductive surgery such as a MIGS surgeon (minimally invasive gynecologist).
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What is laparoscopy minimally invasive surgery?
The fertility specialists at Dallas IVF utilize a laparoscopic minimally invasive form of surgery to view inside the body to evaluate conditions that can cause infertility. When our physician suspects that an abnormality in the pelvic area may be causing infertility, we may recommend a laparoscopy.
In laparoscopic surgery, the surgeon makes a few small incisions (less than a quarter inch) in and below the belly button. The surgeon inserts a laparoscope, which is a small fiber optic camera, to view the pelvic organs, such as the outside of the uterus, fallopian tubes, ovaries and internal pelvic area. The camera sends images to a computer monitor the surgeon views during the procedure.
Diagnostic laparoscopy
Many conditions can be accurately diagnosed with a physical exam combined with other forms of fertility testing. Looking inside the body can be the best approach before undertaking an operation. When laparoscopy is used in this evaluation manner, it is known as diagnostic laparoscopy.
One of the key benefits of laparoscopies – for both surgeon and patient – is the ability to positively diagnose the problem, then correct it at the same time.
Operative laparoscopic surgery
When a surgeon believes the issue can be corrected upon identifying it in diagnostic laparoscopy, they can treat it at the same time. With special operating instruments, such as scissors, forceps, probes, laser or electrosurgical instruments, designed to be used in a tight space under video guidance, a surgeon can remove endometrial tissue, open blocked fallopian tubes, and correct other conditions and anatomical issues causing infertility.
Whether we decide to perform an operative laparoscopy and which type of corrective procedure depends on several factors, including the location of the problem and the extent of the individual’s condition and preferences. Sometimes, if the condition is very advanced, we may recommend one of our colleagues who specialize in reproductive surgery such as a MIGS surgeon.
Benefits of laparoscopy for infertility patients
The American Society for Reproductive Medicine notes four specific benefits for patients.
- Fewer external scars. Smaller incisions of one inch or less mean fewer scars at the belly button and in the lower belly.
- Less scarring internally. Scarring occurs in abdominal surgeries, but laparoscopy can result in less scaring. Scaring from surgery can cause pain, bowel blockage and even problems getting pregnant.
- Less medication and pain. Smaller incisions mean less pain for the patient. That means less medication to address pain, which is needed after open surgeries.
- Faster recovery and fewer complications. Laparoscopy is often an outpatient procedure, eliminating the need for being hospitalized for up to four days as is the case with open surgery. This reduces possible problems such as blood clots and infection.
But laparoscopic surgery may not be right for every patient or circumstance. Our physicians will discuss all issues related to using laparoscopy or traditional open surgery with each patient.
Dallas IVF’s highly qualified laparoscopic surgeons
- Our fertility surgeons are specially trained in laparoscopy and qualified as minimally invasive laparoscopic surgeons.
- Our specialists have performed many successful laparoscopic surgeries.
- We keep abreast of the latest research on best practices and advances in technique and equipment.
Causes of infertility laparoscopic surgery diagnoses and treats
Laparoscopy can help diagnose or repair many gynecological problems that can cause infertility including:
- Pelvic pain.
- Uterine fibroids on the outside of the uterus.
- Endometriosis.
- In cases of unexplained infertility when other evaluations don’t identify a cause.
- Ectopic pregnancy.
- Ovarian cysts.
- PCOS using the ovarian drilling technique.
- Polyps.
- Abnormal uterine bleeding.
- Blocked fallopian tube.
- Scar tissue (adhesions).
- Remove diseased ovaries or damaged fallopian tubes.
What to expect in laparoscopy FAQ
How long does it take and what type of anesthesia is used?
Laparoscopy usually takes about 30-90 minutes to complete. Surgery is performed under general anesthesia so the patient is not awake.
What are the steps in laparoscopy?
- With the patient under anesthesia, the surgeon makes a small incision and injects gas into the abdominal area for better visibility.
- The doctor inserts the laparoscope through that incision and may make additional small incisions as needed for additional instruments.
- The surgeon may inject dye in the fallopian tubes to assess for blockage then try to clear the blockage so sperm and egg can successfully meet in the tube for fertilization.
- Other issues can be treated at this time, such as correcting structural abnormalities, removing scar tissue and removing an ectopic pregnancy.
- Once surgery is complete and the tools removed, the incisions are closed with absorbable stitches.
How long does recovery take?
The patient remains under observation for an hour or two to evaluate for complications. Someone will need to accompany the patient to the surgery center in order to drive them home. We recommend that someone stay with the patient for the next 24 hours. Patients can return to work or their normal routine after a few days.
What are possible laparoscopy risks or complications?
There will be some pain and discomfort afterward but it should be minimal. The surgeon will give the patient specific guidance on recovery instructions and what to expect. Any surgery can have side effects, and those following laparoscopy can include heavy vaginal bleeding, fever, worsening pain and infection. Patients may also experience a couple of days of discomfort as the gas used to inflate the abdominal area leaves the body.
Meet a fertility surgeon, Dr. Sara Mucowski
In this video Dr. Mucowski discusses the laparoscopy minimally invasive surgical procedure, focusing on reviewing a diagnostic laparoscopy.
