Pelvic Endoscopic Assessment

Endoscope is a small telescopic that gives us the ability to see through very small opening (such as the case with laparoscopy) or passing through the neck of the uterus (cervix).

What is laparoscopy?

Laparoscopy is a procedure that involves insertion of a narrow telescope-like instrument through a small incision in the belly button. This allows visualization of the abdominal and pelvic organs including the area of the uterus, fallopian tubes and ovaries.

Why is laparoscopy used for in women with subfertility?

This procedure allows us to determine whether there are any defects such as scar tissue, endometriosis, fibroids and other abnormalities of the uterus, fallopian tubes and ovaries. If any defects are found then they can often be corrected with operative laparoscopy which involves placing instruments through ports in the scope and through additional, narrow (5 mm) ports which are usually inserted at the sides of the lower abdomen.
Laparoscopy has traditionally been a part of the female infertility work-up. However, this tradition has recently been challenged by some, and for the time being is reserved for those with a suspicion of a defect. The issue is complicated, and there are no easy answers. Certainly, some women will have a correctable problem found at laparoscopy that would not have been discovered with other methods.
Because of the cost and invasive nature of laparoscopy it should not be the first procedure or diagnostic test performed as part of the couples infertility diagnostic evaluation. In general, semen analysis, hysterosalpingogram and documentation of ovulation should be assessed prior to consideration of laparoscopy. For example, if the woman has a clear ovulation problem or her male partner has a severe sperm defect then it is unlikely that laparoscopy will provide additional useful information that will help them to conceive.

Is it a big procedure? How much work would I miss?

Laparoscopy is usually done with general anesthesia (you go to sleep). The procedure usually takes between 20 minutes to 2 hours depending upon how much operative corrective work is required.

The woman is generally discharged home from the center approximately two - three hours after completion of the surgery. The woman will usually need to take off an additional 1-2 days from work following the procedure. Mild to moderate pain should be expected to last for up to 7 days or so after the procedure.