Laparoscopy & Hysteroscopy

LAPAROSCOPY & HYSTEROSCOPY

Laparoscopy

Laparoscopy is a surgery that uses a thin, lighted tube put through a cut (incision) in the belly to look at the abdominal organs or the female pelvic organs . Laparoscopy is used to find problems such as cysts, adhesions, fibroids , and infection. Tissue samples can be taken for biopsy through the tube (laparoscope).

In many cases laparoscopy can be done instead of laparotomy surgery that uses a larger incision in the belly. Laparoscopy can be less stressful and may have less problems and lower costs than laparotomy for minor surgeries. It can often be done without needing to stay overnight in the hospital.

What are the advantages of laparoscopic surgery?

Compared to traditional open surgery, patients often experience less pain, a shorter recovery, and less scarring with laparoscopic surgery.

Gynecological diagnosis

In gynecology, diagnostic laparoscopy may be used to inspect the outside of the uterus, ovaries and fallopian tubes, for example in the diagnosis of female infertility. Usually, there is one incision near the navel and a second near to the pubic hairline.

For gynecological diagnosis a special type of laparoscope can be used, called a fertiloscope. A fertiloscope is modified to make it suitable for trans-vaginal application.

A dye test may be performed to detect any blockage in the reproductive tract, wherein a dark blue dye is passed up through the cervix and is followed with the laparoscope through its passage out into the fallopian tubes to the ovaries

Why It Is Done

Laparoscopy is done to:

• Check for and possibly take out abnormal growths (such as tumors) in the belly or pelvis.
• Check for and treat conditions such as endometriosis, ectopic pregnancy, or pelvic inflammatory disease (PID).
• Find conditions that can make it hard for a woman to become pregnant. These conditions include cysts, adhesions, fibroids, and infection. Laparoscopy may be done after initial infertility tests do not show the cause for the infertility.
• Do a biopsy.
• See whether cancer in another area of the body has spread to the belly.
• Check for damage to internal organs, such as the spleen, after an injury or accident.
• Do a tubal ligation.
• Fix a hiatal hernia or an inguinal hernia .
• Take out organs, such as the uterus, spleen , gallbladder (laparoscopic cholecystectomy), ovaries, or appendix (appendectomy). Partial removal (resection) of the colon also can be done.
• Find the cause of sudden or ongoing pelvic pain.
• You may be asked to use an enema or suppository several hours before or the day before the surgery to empty your colon.
• The hospital or surgery center may send you instructions on how to get ready for your laparoscopy or a nurse may call you with instructions before your surgery.
• You will be asked to sign a consent form that says you understand the risks of the test and agree to have it done.

What is Hysteroscopy?

Hysteroscopy is a procedure that allows your doctor to look inside your uterus in order to diagnose and treat causes of abnormal bleeding. Hysteroscopy is done using a hysteroscope, a thin, lighted tube that is inserted into the vagina to examine the cervix and inside of the uterus. Hysteroscopy can be either diagnostic or operative.

Hysteroscopy is the inspection of the uterine cavity by endoscopy with access through the cervix. It allows for the diagnosis of intrauterine pathology and serves as a method for surgical intervention

Why It Is Done

A hysteroscopy may be done to:

• Find the cause of severe cramping or abnormal bleeding. Your doctor can pass heated tools through the hysteroscope to stop the bleeding.
• See whether a problem in the shape or size of the uterus or if scar tissue in the uterus is the cause of infertility.
• Look at the uterine openings to the fallopian tubes. If the tubes are blocked, your doctor may be able to open the tubes with special tools passed through the hysteroscope.
• Find the possible cause of repeated miscarriages. Other tests may also be done.
• Find and remove a misplaced intrauterine device (IUD).
• Find and remove small fibroids or polyps.
• Check for endometrial cancer.
• Use heated tools to remove problem areas in the lining of the uterus (endometrial ablation).
• Place a contraceptive implant (such as Essure) into the opening of the fallopian tubes as a method of permanent sterilization.

What are the benefits of hysteroscopy?

Compared with other, more invasive procedures, hysteroscopy may provide the following advantages:

• Shorter hospital stay
• Shorter recovery time
• Less pain medication needed after surgery
• Avoidance of hysterectomy
• Possible avoidance of “open” abdominal surgery

How safe is hysteroscopy?

Hysteroscopy is a relatively safe procedure. However, as with any type of surgery, complications are possible. With hysteroscopy, complications occur in less than 1 percent of cases and can include:

• Risks associated with anesthesia
• Infection
• Heavy bleeding
• Injury to the cervix, uterus, bowel or bladder
• Intrauterine scarring
• Reaction to the substance used to expand the uterus

When should the procedure be performed?

Your doctor may recommend scheduling the hysteroscopy for the first week after your menstrual period. This timing will provide the doctor with the best view of the inside of your uterus. Hysteroscopy is also performed to determine the cause of unexplained bleeding or spotting in postmenopausal women.