Today there is a significant rise in the percentage of women suffering from some degree of infertility or having other gynaecological problems. In certain cases, couples may find that they can conceive naturally after surgery to restore normal reproductive function. Some of the conditions requiring surgical intervention include, but are not limited to a fibroid uterus, endometriosis, tubal blocks, ovarian cysts, polycystic ovaries, pelvic adhesions and chronic abdomen pain.
Traditionally, if women suffering from such conditions are planning for a surgery, it would be an open surgery which comes with side effects including increasing pain, a minimum scar of 10 cm with stitch marks, increased blood loss added to blood transfusion and its complications, increased chance of wound infection, longer duration to recover post surgery and resume daily activities, increased dependency on others and long duration of hospital stay and leave from work. The solution to reduce the stress induced by open surgery is Laparoscopy. Carbon dioxide gas is allowed to flow into the abdomen prior to inserting the laparoscope. The laparoscope is a thin fibre optic telescope of less than a centimetre, which is inserted into the abdomen. The fibre optics allow a light which is used to see inside the abdomen.
Laparoscopy can either be diagnostic or therapeutic. Generally, laparoscopy should be reserved for couples who have already completed a more basic infertility evaluation, including assessing ovulation, ovarian reserve, ultrasound and hysterosalpingogram for female and semen analysis for a male.
Some conditions like pelvic adhesions and minimal endometriosis with chronic abdomen pain can be diagnosed only through laparoscopy and can be treated at the same time if expertise is available. This gives immense symptom relief to the patient. If a tubal block is diagnosed through hystero-laparoscopy, it can be corrected at the same time by cannulation of the tube with expert assistance. Other indications for laparoscopy are fibroid removal, poly cystic ovarian drilling, and clipping of infected tube before IVF/ICSI to improve the success rate. Laparoscopy comes with the advantages of day care surgery which is more cosmetic than no pain or blood loss and easy recovery from surgery. Patients can resume day to day activities in a day or two.