Laparoscopy is a surgical process which involves making a few small incisions in the abdominal region through which a doctor inserts specialised surgical tools for inspection and minor repairs. It is performed under general anaesthesia and uses carbon dioxide gas to lift abdominal walls, thus allowing easier inspection of the inner organs. It is most prominently used for the removal of scar tissue, a fibroid, or endometrial deposits that can cause pain. In the case of women struggling with infertility, the suitability of diagnostic laparoscopy is still being debated, since it is unknown whether the benefits of the procedure outweigh the risks.
Laparoscopic surgery can help diagnose a cause for infertility, and is usually only performed if all other options have been exhausted, or if symptoms warrant this form of testing. It is recommended in a few cases, such as painful sexual intercourse, severe menstrual cramps or pelvic pain, moderate to severe endometriosis, pelvic adhesions, or a potentially life threatening case of ectopic pregnancy, in which your doctor would remove the abnormal pregnancy from the body and repair any tissue damage. Laparoscopy is generally reserved for couples that have already completed more basic fertility evaluations like ovulation assessment, ultrasound, ovarian reserves, male semen analysis and hysterosalpingogram for women. In some cases, doctors could suspect severe problems. For instance, if a woman has a history of severe pelvic infections or a ruptured appendix, this would increase the likelihood of her having pelvic adhesions and therefore make her more likely to benefit from laparoscopy. Some couples however, choose to skip this treatment in favour of superovulation or intra-uterine insemination or IVF, since these are less invasive, and proven to have much higher success rates.
Undergoing laparoscopic surgery can help eliminate certain causes of female infertility, like hydrosalpinx (blocked fallopian tube), endometrial deposits that cause pelvic pain, or fibroids distorting the uterine cavity. In some cases, women with PCOS are recommended the process of laparoscopic ovarian drilling, which punctures tiny holes into blocked ovaries.
Most risks associated with laparoscopic procedures are consistent with those of any traditional surgery. Bleeding, infections and problems with anaesthesia can occur after any surgical procedure, and the risk of damaging internal organs is equally prominent. Other less common, but potential risks are of hematomas of the abdominal wall, and adhesion formation on the incision scars. Therefore, it becomes imperative to take great care of the patient’s health and well being after surgery. The incision marks are covered with bandages, which can be removed in twenty-four hours. Prescriptions for postoperative pain and nausea must be adhered to carefully. Length of time needed for recovery will depend on the type and intensity of the surgery, as well as the overall health of the patient, keeping in mind any complications that may have occurred during the procedural functioning. While there is no need to panic or worry unnecessarily, certain developments like worsening pain, high fever or fluid secretions like pus or blood should not be ignored and brought to the doctor’s attention immediately.
