Fertility Treatments

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Male pre-treatment screening tests

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Endoscopy / keyhole surgeries

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FAQ

When is laparoscopy recommended?

Laparoscopy is recommended for cases of pelvic pain, dubious test results, infertility, suspected ectopic pregnancy and for the diagnosis of other gynaecological disorders. If during the diagnostic procedure it is revealed that some treatment is needed to resolve the situation then it is possible to switch to an operative approach in one sitting instead of the patient undergoing repeat operation and further anaesthesia.

Laparoscopy can be used to treat:

uterine fibroids and positional abnormalities of the uterus certain disorders of the fallopian tubes and the ovaries various forms of endometriosis that cause intense pelvic pain as well as infertility certain cases of congenital disorder infertility related to adhesions resultant from pelvic inflammation certain urinary disorders

There are different options to perform laparoscopy: (Prior to the procedure is always consulted with the patient which type is recommended)

During classic laparoscopy the abdominal cavity is distended by CO2 gas through a special needle in order to achieve better visualization of the inside. Then the laparoscope is inserted into the abdomen through a small (approximately 1 cm long) umbilical (belly button) incision. During open insertion - usually if the patient had previous surgery - a small (2-3 cm long) incision is made below the belly button and the scope as well as the gas is entered through this. This method is used when the medical history of the patient entails periumbilical adhesions therefore complications in entering the abdomen. The abdominal and pelvic cavities are sometimes distended through the vagina and the scope is also inserted vaginally.

The technique of choice is always consulted with the patient prior to the procedure.

Frequently during laparoscopy the uterus is sounded to move the uterus away in order to improve visualization of the pelvis. When laparoscopy is performed for indications of infertility sounding is also used to enter ink into the uterine cavity and the tubes in order to determine their patency. This procedure is called chromopertubation.

Anasthesia

Laparoscopy is usually performed under general anaesthesia. Anaesthesia during laparoscopy is special in that the patient is in Trendelenburg position - i.e. her head is slightly lowered - so that the abdominal organs move out of the pelvis, allowing for better visualization.

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