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During operative laparoscopy, many problems that cause infertility can be safely treated through the laparoscope at the same time that the diagnosis is made. When performing operative laparoscopy, additional slender instruments such as probes, scissors, biopsy forceps, coagulators and suture materials are placed into the abdomen, either through the laparoscope or through two or three additional tiny incisions called "suprapubic punctures", which are made above the pubis.
Some of the disorders that can be corrected with the help of the aforementioned procedure include: releasing scar tissue and/or adhesions from around the fallopian tubes and ovaries; opening blocked tubes; and removing ovarian cysts. Burning the endometriotic lesions on m the uterus, ovaries, or peritoneum during operative laparoscopy can also destroy endometriosis. Under certain circumstances, small fibroid tumors can be removed and ectopic pregnancies can be treated.
When performing operative laparoscopy, surgeons may use electrocautery instruments, lasers, and sutures. The choice of the technique used depends on many factors including the surgeon's training, location of the problem, and availability of equipment.
Sometimes, a "second-look" laparoscopy may be recommended. This procedure is performed following either operative laparoscopy or major tubal surgery. Second-look laparoscopy can take place within a few days following the initial surgery or many months afterwards. During the procedure, the doctor determines whether adhesions are re-forming or if endometriosis is returning, and these conditions can be treated in needed.
After surgery, the patient needs to rest for about 2 to 4 hours in order to recover from the effects of anesthesia. She can usually go home the same day and resume normal work in 2 to 3 days. Sexual activity can be resumed in a week or so, depending upon the doctor's advice.
After the operation, there may be some discomfort. This may include:
Most of these minor symptoms will disappear within a day or two after surgery. The abdomen may feel swollen for a few days. Any unusual or peculiar symptoms should be reported at once to the doctor.
To really appreciate the benefits of laparoscopy, one should remember that the alternative is major surgery (laparotomy) which involves a large abdominal incision, a four = to six = day hospital stay, and four to six weeks of postoperative recovery time.
While the doctor may term laparoscopy as being "minor" surgery, remember that for the patient all surgery is major! The risks of laparoscopy are minimal, but certain conditions increase the possibility of complications. If there has been previous surgery in the abdomen, especially involving the bowel, there is an increased risk. Other conditions that lead to a higher risk of complications are evidence of an infection in the abdomen, a large growth or tumor within the abdomen, and obesity.
Complications among young, healthy women undergoing laparoscopy are rare and occur only in about three out of 1000 cases. These complications can include injuries to structures in the abdomen such as the bowel, a blood vessel or the bladder. Most often, these injuries occur when the laparoscope is placed through the navel. If such an injury occurs during the procedure, the physician can perform major surgery and correct the damage through a longer abdominal incision. Sometimes, complications may arise after surgery. If bleeding or pain appears excessive or if high fever develops, the doctor should be informed.
© Dr. Aniruddha Malpani and Dr. Anjali Malpani www.drmalpani.com
Credits: How to Have a Baby: Overcoming Infertility
