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Fig 2. Normal pelvis as seen during a laparoscopy. The uterus is the reddish structure in the center; on either side of which are the pink fallopian tubes. These run towards the ovaries, which are white in color.
As stated earlier, along with laparoscopy, some doctors carry out a dilatation and curettage (D & C) and send the endometrial curettings for histologic examination to rule out the possibility of hidden tuberculosis, and also to find out if ovulation is taking place. Others will do a diagnostic hysteroscopy at the same time, to ensure that the uterine cavity is normal.
Another technique available now is called videolaparoscopy. It is possible to connect a video camera to the laparoscopy, so that what the surgeon sees can be displayed on a TV monitor. This kind of laparoscopy can be very useful for documentation and record keeping. It is also very helpful for patient education; since the doctor can use the video later on to explain to the patient the exact nature of her problem.
Recent advances in miniaturization have allowed companies to manufacture very tiny laparoscopes. These are as thin as a needle, and are called microlaparoscopes or needle scopes. These allow doctors to perform laparoscopy in the clinic itself, without using anesthesia. However, the quality of the images with these tiny scopes is still not very good.
Dr Brosens from Belgium has also introduced the technique of transvaginal hydrolaparoscopy. This allows the doctor to examine the pelvis by inserting a tiny scope through the vagina, so that no abdominal incision needs to be made. The value of this technique as compared to conventional laparoscopy is still being studied.
© Dr. Aniruddha Malpani and Dr. Anjali Malpani www.drmalpani.com
Credits: How to Have a Baby: Overcoming Infertility
