Fertility enhancing surgeries like diagnostic hysteroscopy/laparoscopy and, if necessary, operative hysteroscopy/laparoscopy are mandatory to improve reproductive outcome. They are simple, safe, quick, well-tolerated, and low-cost surgical procedures, with no need for a major operating room. All Milann centres are equipped with the latest hi-tech equipment to perform advanced endoscopic surgeries that are needed to improve success in assisted reproduction. Most of the surgeries are daycare procedures which allows you to get back home the same day. Most commonly performed surgeries for an infertility workup are diagnostic laparoscopy and diagnostic hysteroscopy which are done to evaluate the tubes and the uterine cavity. Scarring of tubes or peritubal adhesions which are very often the cause for not conceiving, may not be identifiable on a routine scan but can easily be seen and corrected at the time of laparoscopy. Sometimes a blocked tube as seen in a hysterosalpingogram(test is done to check for patency of tubes) may be seen as a patent on laparoscopy! Hence laparoscopy is a more reliable diagnostic tool than ultrasound or HSG The need for diagnostic surgeries is tailored to suit each patient. But operative endoscopic surgeries are done for patients who have uterine fibroids, endometriosis, engorged tubes with fluids called as hydrosalpinx or any other problems inside the uterine cavity like polyps, scars etc. These procedures help to correct tubal obstruction by cannulation or tubal reversal, excision of uterine fibroids, endometriosis and scarring following which the fertility expert can decide whether the patient needs to go for simple treatments like IUI for enhancing pregnancy success or more higher treatment like IVF.
The most important aspect of minimally invasive surgery is that unlike conventional surgeries, which require large incisions and retraction, a minimally invasive approach achieves the same outcome with less trauma and stress. This means less pain, fewer complications, less blood loss, smaller surgical scars, and a faster recovery. In most cases patients leave the hospital the same day and quickly return to normal activities
This is a procedure where a telescope-like instrument is inserted into the abdominal cavity through a small incision most commonly done through the umbilicus. The beauty of the surgery is that through this small hole the whole of the abdomen can be seen magnified on the TV like screen. The surgeon visualizes the uterus, ovaries and tubes, whether the tubes are blocked, presence of any adhesions or fibroids, whether the ovary is normal etc. Any minor surgical correction like drilling of ovaries in case of PCOS, the release of adhesions etc can be done in the same sitting.
Here a telescope is passed inside of the uterus through the vagina and cervix which are natural openings. The inside of the uterine cavity can be visualized. Sometimes scars, small growths like polyps can be seen which may not be seen on the scan. Uterine abnormalities are also made out and corrected as required. The patient is discharged the same day and can get back to work in a few days time!
The benefits of minimally invasive surgery are the following
It has definitely been shown that endoscopic surgery is efficacious and can provide better results than more conventional surgery.
Dr. Vandana Krishna Prasad
Consultant Rep Med Specialist, Milann
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