Laparoscopy in infertility: effectiveness, training, recovery
Female infertility is an important medical and social problem. Thus in gynecology this condition may be due to the large number of causes, some of which are quite difficult to detect. For the diagnosis of possible diseases using a wide range of treatments, starting with clinical examination and ending with the implementation of magnetic resonance imaging, etc. However, the most informative method of diagnosis of gynecological diseases is diagnostic laparoscopy for infertility. It is an endoscopic method of examination of internal organs of the abdominal cavity, combining high efficiency and safety.
Laparoscopy for infertility is conducted in accordance with all regulations and is only possible in the operating room. After preliminary preparation women spend anesthesia, which can be of two types: spinal, or General anesthesia. When spinal anesthesia option the woman retains consciousness at the time of the survey.
However, the method has a number of limitations that are drawbacks:
- Requires specially trained operating team for laparoscopic interventions.
- Possible damage to internal organs due to the small volume of the surgical field.
Assessing all the advantages and disadvantages of the procedure, the doctor selects the most appropriate tactics for every woman with infertility. This allows to increase the efficiency of examination and to minimize possible health risks.
Laparoscopy for infertility of unknown origin allows you to identify the cause of this condition and to determine further tactics of treatment or examination. Thus physician can do a photo or video of the procedure for further analysis or evaluation of the effectiveness of therapy. The most important advantage of laparoscopic procedures is the possibility of biopsy of the female genital organs, followed by morphological analysis that allows you to set the most accurate diagnosis.
Female infertility may be due to the large number of diseases of the pelvic organs.
It is possible to identify the following pathological status during laparoscopy:
- Endometriosis is characterized by abnormal location of the lining of the uterus that leads to bleeding and inflammation in organs of small pelvis and abdominal cavity and can cause infertility in women.
- Fibroids or multiple fibroids develop on the background of violations in the hormonal system of women. This benign tumor of the muscular tissue of the uterus, often without clinical symptoms, but leads to deformation of the body.
- Chronic diseases of the pelvic organs and reproductive system inflammatory in nature, can lead to the development of adhesions and disruption of the fallopian tubes and uterus.
- Polycystic ovarian cysts or an individual can cause the development of infertility or malignant tumor growth.
- Commissural lesions of the pelvic organs. It is a major problem in gynecology due to the high risk of infertility in women patient.
All of these condition can cause infertility. Diagnostic laparoscopy allows to identify such pathological processes, to assess their intensity and to find the optimal and rational treatment strategies.
Preparing women for the procedure
Providing adequate training women to laparoscopy allows to reduce the likelihood of negative consequences. The best time to test ovulation. If this time is not possible, then the procedure was carried out three days before or after menstruation. In the month preceding the survey, the woman should avoid sexual intercourse to prevent pregnancy due to the fact that hormonal contraceptives are prohibited to use.
2-3 days before the operation, the woman does General blood and urine tests, blood tests for a number of infectious diseases (HIV, viral hepatitis, etc.), as well as EKG and x-rays of the chest. Mandatory stage – ultrasound examination of small pelvis organs. After that, if the contraindications to testing were not revealed, the doctor and the anesthesiologist spend with a woman the conversation, describing her forthcoming studies and possible risks.
Proper preparation of the inspection – the key to high information content and security studies.
Also a woman should perform a number of simple guidelines:
- 3-4 days before the laparoscopic surgery is necessary to exclude from food all foods that contribute to gas production: bakery products, fruits and vegetables, legumes, etc.
- For 4-7 days before the study exclude the taking of medicines unless they are needed to maintain the life of the patient.
- The day before the operation the woman of colon cleansing that can be done by setting an enema or using drugs.
Once the woman is ready for the upcoming examination, proceed to laparoscopic surgery.
How is laparoscopic diagnosis?
The necessary stage of the survey – organization of General or spinal anesthesia by the anesthesiologist. The woman is placed on the operating table, where she carefully treated the skin on your abdomen for disinfection.
The first phase of laparoscopy – inflating the abdominal cavity of the patient with carbon dioxide gas, which is introduced there through a special tool. This allows to improve the area of examination of the internal organs and provides space for surgical manipulation. Then insert the laparoscope consists of a flexible probe with a camera and a light source at the end, as well as additional tools. All of this is done through small incisions on the skin of the abdominal wall.
During visual inspection of the pelvic organs attending physician is able to identify pathological processes and, if necessary, to biopsy for the implementation of the differential diagnosis.
After the completion of the inspection instruments are carefully removed from the abdomen, and the incisions are carefully sutured. The woman placed one day in the ward under constant supervision of specialists.
The recovery period
For a successful recovery after this procedure, the laparoscopy is very important to provide adequate rehabilitation, which should commence prior to surgery. Each patient before the examination put on feet special compression stockings or elastic bandages to prevent blood clots in the lower extremities. A few hours after the operation and return of consciousness, the woman is recommended to get out of bed and walk with her within the chamber. This improves blood flow and reduces the risks of blood clots.
It is important to provide proper nutrition for the patient with a high content of vitamins and nutrients. It is recommended to stick to the diet with the exception of food fat, salt and other harmful products.
Conducting diagnostic laparoscopy allows to identify the causes of infertility, to make a differential diagnosis between different States in severe cases and prescribe the most appropriate treatment. Due to the low risk of early and late complications, laparoscopy is the gold standard to identify the causes of infertility with unclear clinical picture.