According to HFEA (Human Fertilization & Embryology Authority) from the UK, 30% of infertility is due to abnormalities related to female reproductive organs. Some factors that might cause infertility are:
- Hormone deregulation,
- Lack of ovulation,
- Obstructed tubes,
- Polycystic Ovarian Syndrome (PCOS),
- Adhesions due to previous abdominal surgeries,
- Pelvic inflammation disease (PID) due to Sexually Transmitted Infections (STI’s)
It is a surgical procedure, which allows the surgeon to assess the whole abdominal cavity. Information for the upper and lower abdomen is obtained under direct vision, while biopsies taken at that time can give us additional histological information. Uterus, tubes, and ovaries are examined in detail, while other abdominal organs such as bowel, liver, gallbladder are visualized.
We cannot perform this procedure under local anesthesia. The procedure requires full sedation, with an estimated surgical time usually less than one hour. A small incision is performed on the umbilicus through which a very thin camera is introduced on the abdomen. If the patient has consented upon it, the surgeon will decide whether to proceed with further surgery or findings suggest a different treatment pathway.
Laparoscopy can diagnose and treat the underlying causes that accumulate and cause infertility.
Confirmation for abdominal pathology such as endometriosis, abdominal adhesions (scarring from previous surgeries), ovarian cysts, fibroids, an ectopic pregnancy occurs by laparoscopy. At the same time, an ultrasound scan or MRI suggests strong or mild indications.
While the abdominal cavity is assessed through laparoscopy, the uterine cavity is evaluated through another procedure that is called hysteroscopy. No skin incisions needed. Through natural orifices, we insert a very thin camera to assess the lining of the uterus. This optical system has a lighting source and an insufflation system that uses water to distend the inside of the uterus. Other procedures, such as laparoscopy, can be performed at the same time if indicated by patients’ symptoms. Diagnosis and treatment of the following can happen at the same time:
- Endometrial polyps,
- adhesions inside the uterine cavity
- Fibroids that lie within the uterine cavity or protrude in the cavity from the uterine wall
Hysteroscopy is considered a minor procedure and doesn’t require an overnight stay in the hospital. It is a cornerstone procedure during the process of treating infertility.
Apart from that hysteroscopy is indicated to diagnose and treat
• Pelvic pain
• Recurrent miscarriages
• Abnormal uterine bleeding due to polyps or fibroids
• Infertility due to adhesions
• Infertility due to a defect in the shape or size of the uterus
• Infertility due to polyps and fibroids
• Recovery of displaced or shuttered intrauterine device (IUD)
We cannot perform hysteroscopy when a woman is pregnant, or there is an active pelvic or vaginal infection.
The ideal timing for hysteroscopy is immediately after the end of menstrual bleeding. This procedure lasts from 10 to 30 minutes.
It is feasible and safe to perform Hysteroscopy and Laparoscopy during the same surgical session..
Benefits of Robotic-Assisted Laparoscopy
Less estimated blood loss
Earlier oral intake
Lower wound infection rates
Lower post-op bleeding
Shorter hospital stay (typically overnight stay)
Better cosmetic results
Quicker return to normal activities
Robotic-Assisted Laparoscopic for infertility treatment
Surgeons dedicated to performing minimally invasive procedures are committed to personalized treatment for every individual patient. Robotic-assisted procedures are considered safe and effective. It is appropriate for most patients, but not for all.
Let’s discuss your treatment options.
If you are a surgical candidate for robotic surgery, skilled robotic surgeons with high-end equipment will be able to offer you treatment and relief of your symptoms.