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Laparoscopy and Hysteroscopy

Laparoscopy and hysteroscopy facts

  • The minimally invasive surgeries of laparoscopy and hysteroscopy are two of the most common fertility surgeries performed to diagnose and treat causes of infertility.
  • In a laparoscopy, our surgeon makes small incisions in the abdomen and a small fiber optic camera (called a laparoscope) is inserted to examine the abdominal/pelvic area, including the exterior uterus, fallopian tubes and ovaries, which the surgeon views on an external monitor.
  • In a hysteroscopy, a small camera called a hysteroscope is inserted through the cervix to examine the interior of the uterus, viewed on a monitor.
  • Our fertility surgeons can often correct anatomical abnormalities and conditions during a laparoscopy or hysteroscopy.
  • With laparoscopy and hysteroscopy, typically done on an outpatient basis in our surgery center, patients recover more quickly and have fewer risks than they do from traditional “open” abdominal surgery.

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What are laparoscopy and hysteroscopy?

Laparoscopy and hysteroscopy are minimally invasive surgeries that allow us to take a closer look at the reproductive systems of women (or transgender men), find abnormalities and correct them. They are two of the most common fertility surgeries to diagnose and treat infertility issues in patients.

When our physician suspects that an abnormality in the pelvic area may be causing infertility, we will perform a laparoscopy. In laparoscopic surgery, we make a few small incisions (less than a quarter inch) in and below the belly button. We insert 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.

A hysteroscopy requires no incisions. We insert a small camera through the cervix and into the uterus. The surgeon can view the lining of the uterus (endometrium), with images sent from the camera to a monitor. Sometimes we perform a hysteroscopy to repair problems that have already been revealed by in-office diagnostic procedures such as a hysterosalpingogram or saline sonogram.

If we find abnormalities, often we can repair them during the same procedure, avoiding the need for another surgery. Once the issue has been identified or confirmed during these procedures, our surgeons insert small instruments the same way they inserted the camera: through small incisions during a laparoscopy or through the cervix during a hysteroscopy. They use those instruments to repair or correct the cause of infertility.

Laparoscopy and hysteroscopy are usually outpatient procedures, requiring no overnight stays in the hospital.

Our fertility surgeons perform laparoscopies and hysteroscopies in our convenient, state-of-the-art surgery center.

Who needs these minimally invasive surgeries to treat causes of infertility?

We typically use laparoscopy or hysteroscopy if we suspect anatomical problems are preventing the person from getting pregnant or maintaining a pregnancy. Studies have shown that correction of these abnormalities can increase patients’ chances of conceiving a baby on their own or improve their chances of successfully conceiving through in vitro fertilization (IVF).

Laparoscopy and hysteroscopy can help diagnose or repair many gynecological problems that can cause infertility including:

We perform tubal ligation reversal that undoes that form of sterilization through mini-laparotomy, which combines the benefits of laparoscopy and open surgery.

Benefits of laparoscopic surgery & hysteroscopy surgery

Because laparoscopic surgery and hysteroscopy are minimally invasive surgeries requiring small or no incisions, they have multiple benefits:

  • Quicker procedures.
  • Less pain.
  • Shorter recovery times.
  • Lower risk of scar tissue and infection.
  • The ability to identify and correct problems without the need for a second procedure in most cases.

 

Common questions about laparoscopy and hysteroscopy

What can I expect during a laparoscopy or hysteroscopy?

Laparoscopy usually takes about 30-90 minutes to complete. Surgery is performed under general or local anesthesia. Surgeons make small incisions in and below the navel. Once surgery is complete, the incisions are closed with absorbable stitches.

Patients can return to work or their normal routine after a few days. Hysteroscopy takes anywhere from 5 to 30 minutes to complete, depending on whether we are investigating symptoms or treating an issue. Surgery is performed with either a local or general anesthesia. Patients go home the same day and can often return to work or normal activity the next day.

After the procedure, our physician will explain the results and present possible next steps. If we recommend IVF or another fertility treatment, the patient may be advised to wait several weeks or more to allow the body to fully recover from surgery.

What if I’m not a candidate for a laparoscopy or hysteroscopy?

Some women have reproductive abnormalities that can’t be treated with minimally invasive surgeries such as laparoscopy or hysteroscopy. In these cases, we typically recommend a more traditional open surgery, using a larger abdominal incision. The most common type of abdominal procedure we perform is an abdominal myomectomy for the removal of large uterine fibroids. Most open abdominal surgeries require a one- or two-night hospital stay. Most patients return to work within four weeks.

Risks of laparoscopy and hysteroscopy

Less than 2% of patients have complications from laparoscopy and hysteroscopy. Complications are typically minor and can include:

  • Infection and skin irritation at the incision.
  • Internal bleeding.
  • Complications from anesthesia (vomiting, nausea, headache, allergic reaction, lung infection).
  • Formation of scar tissue.
  • Accidental damage to the womb or cervix.