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Many couples' difficulties in conceiving a baby are caused by anatomical disorders in the female partner. However, detecting anatomical disorders in infertility cases is sometimes a challenge for fertility experts and endocrinologists.
The location of the uterus and ovaries, which are hidden in the pelvic cavity, makes the diagnosis of anatomical abnormalities not enough using physical examination and ultrasonography alone, but requires advanced examinations such as MRI, hysteroscopy and laparoscopy.
With the development of today's technology, endoscopic examination can not only provide a more definitive diagnosis, but also provide accurate treatment (see and treat procedure). So now couples can find the best solution to get a baby with their partner without having to go through a stressful procedure (laparotomy).
The world of medicine has presented the latest surgical methods (laparoscopy, hysteroscopy) that can help find and overcome the problems of infertility cases without having to perform major surgical operations (Fertility-enhancing surgery).
What is Endoscopic Surgery ?
Endoscopic surgery is a surgical technique that uses optics to view the surgical field. In obstetrics and gynecology, endoscopic surgery includes hysteroscopy, laparoscopy, fertiloscopy, fetoscopy and colposcopy.
In laparoscopic surgery, this minimally invasive surgical technique inserts a camera into the abdominal cavity using a small 10 mm incision as a visualization tool for the operating field, and a small 7 mm incision as an extension of the operator's hand to perform the surgery. In comparison, the minimum incision required during laparotomy (conventional surgery) is 10 cm (100 mm).
Another surgical technique that is very reliable in detecting abnormalities in the uterine cavity is hysteroscopy. In hysteroscopy, a camera is used to view the condition inside the uterus (cavum uteri), so that micro-scale abnormalities (micropolyps, endometritis, adhesions) can be detected easily as well as repaired in one shot (see and treat).
Unlike colposcopy, here the optical power of magnification is used in examining the condition of the uterine mouth. With this method, the accuracy of diagnosis of abnormalities in the uterine mouth can be detected more accurately.
What can be done in Laparoscopic Surgery ?
The use of laparoscopic tools can be used to identify problems that occur in the abdomen, such as digestive problems, kidney - urinary tract, and the female reproductive system.
This method has helped many couples in identifying fertility problems so that doctors can determine the best pregnancy plan and the chances of achieving pregnancy are better.
The use of laparoscopy can be used to identify and treat abnormalities such as:
- Congenital abnormalities of the uterus, fallopian tubes, and ovaries.
- Infections of the pelvic cavity or pelvic inflammatory disease.
- Benign ovarian tumors such as ovarian cysts, dermoids, endometriosis.
- Benign tumors of the uterus: uterine myoma, adenomyosis.
- Ectopic pregnancy.
- Gynecologic cancers: including ovarian, uterine and cervical cancers.
Preparation for Laparoscopic Surgery
Before laparoscopic surgery is performed, your doctor will usually ask you to undergo imaging tests. This is to determine whether you need laparoscopic surgery or not. If the imaging results are not conclusive, the doctor will advise laparoscopic surgery.
On the day of the scheduled surgery, the doctor will ask you to empty your bladder and digestive tract, as well as fast for 8 hours and not to consume any food and drink before the surgery.
What is the Laparoscopic Surgery Procedure Like ?
The process of performing laparoscopic surgery usually takes only 30 - 60 minutes depending on the initial diagnosis and plan of action. You will be given anesthetic medication so that you will not feel any pain during the surgery.
The doctor will begin the surgery by making a small 7-10 mm incision in the umbillicus or abdominal area (optic trocar). This incision allows the surgeon to insert a laparoscopic optical instrument (laparoscope) into the abdomen as well as a tube that can pump the stomach with gas so that the doctor can see the contents of the stomach clearly.
The laparoscope itself is equipped with a camera at the end which is useful for taking clear pictures. The doctor will examine several parts of the abdomen to look for abnormalities or problems that need to be treated (diagnostic laparoscopy). If a treatable problem is found, the doctor may make several more small incisions (working trocar - 7 mm) to treat the problem.
Once the surgery is complete, the gas and instruments are removed and the doctor closes the incisions with stitches. You will then be taken to the recovery room where the doctor will monitor your condition overnight. Once the recovery process is complete, you will be allowed to go home.
What are the Side Effects of Laparoscopic Surgery ?
There are some risks or side effects that may occur after laparoscopic surgery is performed, but the percentage of these risks is known to be very small. Minor risks that may occur include:
- Infection.
- Minor bleeding and bruising around the incision.
- Nausea and vomiting.
- Abdominal bloating.
- Mild reaction to anesthesia.
And some more severe risks such as:
- Bleeding and the potential need for a blood transfusion
- Injury to internal structures, such as blood vessels, stomach, intestines, bladder, or ureters.
- Blood clots in blood vessels (thrombosis, embolism).
- Complications arising from the use of carbon dioxide gas (subcutaneous emphysema).
- Severe allergic reaction from anesthetic drugs.
What to Watch Out For After Laparoscopic Surgery ?
After laparoscopic surgery, you can usually return to your normal activities after resting for 1 - 2 days. However, some symptoms may still be felt due to post-operative effects, such as:
- Fatigue.
- Flatulence.
- Shoulder and back pain.
- Pain in the area of the incision stitches.
These symptoms will resolve on their own by resting and taking the prescribed medication given by the doctor. However, if the symptoms do not go away after 3 days or even increase, consult your doctor again immediately.
What Specialists Perform Laparoscopic Surgery ?
To consult about laparoscopic surgery, you can see an Obstetrician and Gynecologist (Sp.OG), they will also need the help of an Anesthesiologist in the process of performing the surgery.
Thank you for reading this article. Have a nice day.
