HYSTERO LAPAROSCOPY + ADHESIOLYSIS

Hysteroscopy
A hysteroscopy gets its name from the thin telescope-like viewing device, called a hysteroscope, which is used during the procedure to let the doctor see inside your uterus. Usually performed by your reproductive endocrinologist (RE), a diagnostic hysteroscopy is done in office, without anesthesia. The procedure takes about 10 minutes but could take longer if the doctor finds something that can be corrected at the same time. (An operative hysteroscopy is done if there’s evidence of fibroids or polyps that need to be removed. This is an out-patient procedure in a hospital or surgery center.)

A hysteroscopy is used to see if your fertility problems are due to scar tissue or to problems with the shape or size of the uterus due to fibroids or polyps. It may also determine the cause of repeated miscarriages.

During the test, the doctor is able to not only find, but to treat, several other problems. For example, s/he can remove any small fibroids or polyps s/he finds during the procedure. The doctor may also be able to stop abnormal bleeding or remove a blockage in the fallopian tubes. If there are problem areas in the endometrial lining of the uterus, the doctor can remove them.

Laparoscopy
A laparoscopy uses a small telescope-like tube called a laparoscope to let the doctor see the outside of your uterus, ovaries, and fallopian tubes. A laparoscopy takes about 30 to 90 minutes but can take longer if the doctor finds something that can be corrected at the same time. It is usually done under general anesthesia, and most women go home the same day.

The test determines if there is a blockage in the fallopian tubes or if you have endometriosis or scar tissue that could be causing fertility problems. This procedure also allows the doctor to find and treat conditions such as endometriosis or pelvic inflammatory disease (PID, a pelvic infection which can cause infertility).

Adhesiolysis
Laparoscopic adhesiolysis was first described by a gynecologist for the treatment of chronic pelvic pain and infertility. In the early days of laparoscopy, previous abdominal surgery was a relative contraindication to performing most laparoscopic procedures. Laparoscopic surgery to relieve bowel obstructions was not routinely performed.Many case series have documented this technique. Advanced technology with high-definition imaging, smaller cameras, and better instrumentation have allowed for an increasing number of adhesiolysis to be performed laparoscopically with good outcomes.

Compared with the open approach to adhesiolysis, the laparoscopic approach offers the following:

• Less postoperative pain
• Decreased incidence of ventral hernia
• Reduced recovery time with earlier return of bowel function
• Shorter hospital stay