Laparoscopic Surgery

Laparoscopy is a procedure consisting of the introduction of an optical instrument through a 1-cm (0.40 in) incision in the navel. The specialist works on the woman’s pelvis through this incision and other two 0.5-cm (0.20 in) cuts. It is a minimally invasive surgery which has the purpose of diagnosing and treating various kinds of gynecological diseases. It is usually performed on infertile women who very often get pregnant after this procedure.

When should it be performed?

1) When the specialist suspects an endometriosis either because of ultrasound results or the woman’s symptoms.

Endometriosis

Endometriosis

2) When there is a history of previous surgeries such as Apendectomy, Peritonitis, D&C (Dilation and Curettage) etc., and the specialist suspects the existence of adhesions.

3) When we detect uterine myomas which can be laparoscopically removed. 4) In unexplained infertility, when after performing basic infertility tests we cannot find any reason for it. 5) When we observe the presence of cysts of different origin which could not be eliminated with other medical treatments. 6) Other cases of gynecological pathology unrelated to infertility.

What is the procedure like?

The specialist performs it under general anesthesia, working with very sophisticated instruments through three incisions which are less than 1 cm long. In this way it is possible to remove cysts, release adhesions, coagulate foci of endometriosis, etc., improving the pelvis condition with the purpose of preparing it for pregnancy. The patient remains only 8 hours as an inpatient and then she may go home by her own means.

Pregnancy rates with laparoscopic surgery:

When laparoscopy is performed with a reproduction criterion, taking maximum care of pelvic organs involved in conception and pregnancy (ovaries, tubes and uterus) the condition is always improved and chances after the surgery are clearly higher. After laparoscopy, the patient very often gets pregnant soon, provided there are no other infertility factors involved. In these cases, surgery should be complemented with other treatments like ovarian stimulation, inseminations or assisted reproduction.

Hysteroscopic Surgery

The uterine cavity is the site where embryos spontaneously implant for the normal development of pregnancy. This cavity must be “normal”, that is, capable of allowing implantation, but it very often shows abnormalities such as myomas, which are rounded growths of uterine tissue which deform the cavity. There may also be polyps, which are growths of abnormal tissue; synechiae, which are adhesions; septa, etc., all of which are growths interfering with implantation or the development of a normal pregnancy.

Hysteroscopy is a procedure by which an optical instrument is introduced into the uterine cavity through the vagina making it possible not only to diagnose the different pathologies but also to cure them either by releasing the adhesions, resecting polyps or myomas and leaving the cavity ready for conception and pregnancy. This procedure is performed under local or general anesthesia, depending on whether it is diagnostic or operative (surgical). Even in the most complex cases which are performed under general anesthesia, such as the resection of myomas or septa, the patient is released 3 hours after surgery and she can be back at work in two days.