Surgical correction of problems in women causing infertility can be done in 3 ways
1. Reproductive Microsurgery by opening the abdomen (laparotomy)
- Tubal Reconstructive surgery is performed under magnification in women who have undergone tubal occlusive surgery like tubal ligation and wish to have tubal recannalization to preserve their fertility. However, now with the development of laparoscopic surgical procedures tubal recanalization can be done with great precision endoscopically.
2. Reproductive surgery under normal vision (non-magnified) by laparotomy
- All procedures done endoscopically can also be done by open surgical techniques such as tubal reconstuction, removal of ovarian cysts of all types, removal of fibroids and pelvic resurrection. However, laparoscopic surgery gives better visualization and precision of all these procedures with lesser post operative complication and adhesion formation.
3. Endoscopic correction of pelvic pathologies
Endoscopy is the examination and inspection of the interior of body organs or cavities using a device called an endoscope. Our unit performs all fertility promoting endoscopic procedures. Endoscopy involves laparoscopy as well as hysteroscopy.
Laparoscopy involves visualization of pelvic structures (uterus, tubes & ovaries) with the help of a special optical device called as laparoscope. Operative intervention can be done simultaneously, which helps in restoring the pelvic anatomy & improving your chance of conception.
Hysteroscopy is a surgical procedure that enables us to diagnose and operate on pathologies inside the cavity of the uterus. This consists of the introduction of an instrument with fibre optics called hysteroscope, through the cervical canal, which enables us to visualize the cavity of the uterus. We can diagnose and treat any existent uterine pathologies simultaneously.
We have state of the art, fully equipped dedicated theatres where these endoscopic procedures are performed usually as day care procedures and the patient does not need to be admitted overnight.
a. Laparoscopic surgeries promoting fertility
- Laparoscopic resurrection of pelvic structures by fertility promoting procedures which involve releasing adhesions between ovaries, tubes & uterus, due to past pelvic infection or pelvic endometriosis or previous surgeries in pelvis or surrounding structures in the abdomen
- Removal of ovarian cyst such as endometriotitc cyst, dermoid cyst, other ovarian tumour or cyst
- Tubal corrective surgeries for tubal blocks: proximal end tubal blocks- hysteroscopic tubal cannulation, for distal or fimbrial end tubal blocks- fimbrial dilation or ostia formation by salpingostomy.
- Removal of most uterine fibroids which are intra mural or subserosal in location
- Ectopic pregnancy: Managing tubal pregnancy endoscopically by saving or removing the tube with the ectopic pregnancyas the case may warrant
- Pre IVF tubal occlusion in cases of gross hydrosalpinx
- Surgery for twisted ovary: de-torsion or removal as the case may warrant
b. Hysteroscopic surgeries to promote fertility
- Uterine cavity assessment & directed biopsy
- Hysteroscopic cannulation