Salpingoscopy is performed at the time of laparoscopy, and involves the insertion of a viewing instrument called the salpingoscope through the ends of the fallopian tubes. This enables a view of the distal portion of the tubal mucosa, and helps to diagnose hydrosalpinx, areas of thinning (denudation) and scarring (adhesions) within the tube, which are major causes of infertility.
Infertility Laparoscopy for Diagnosis and Treatment of Tubal Factor Infertility
Laparoscopy is considered the gold standard for the detection and treatment of tubal disease, and should be considered in any patient with risk factors for tubal disease such as a history of sexually transmitted disease, pelvic inflammatory disease, previous pelvic surgery, or appendectomy. Despite what you may have heard, tubal reversal (revering a previous tubal ligation) is not straightforward or easy, and is not a major focus of our practice.
Laparoscopy is a minimally invasive surgical procedure that allows the surgeon to both view and treat anatomic abnormalities by using a very small fiber-optic lens inserted through a small incision in the navel. If necessary, additional small incisions are made to allow the use of other specialized surgical instruments during the procedure. Because laparoscopy lets the surgeon perform exploratory surgery to reveal pelvic defects, as well as perform surgical excision to treat these defects – all in one minimally invasive operation – it has become an invaluable part of infertility diagnosis and treatment.
How is laparoscopy performed?
For an infertility laparoscopy procedure, your surgeon will:
- Administer general anesthesia.
- Insert the laparoscope, which is a bright, lighted fiber optic tube, through a small abdominal incision; surgical instruments that may be required are also inserted.
- Fill the abdomen with carbon dioxide gas. This causes the abdominal cavity to expand, giving your surgeon a clear view of the reproductive organs.
- Evaluate the outside of the uterus and fallopian tubes for anomalies and repair them surgically.
- Laparoscopy is done during the early part of the menstrual cycle to avoid disruption of possible early pregnancy.
Laparoscopy is Useful for Diagnosis and Treatment (Removal) of:
- Endometriosis lesions
- Ovarian cysts
- Uterine fibroids
- Tubal adhesions
- Hydrosalpinx
Advantages of Laparoscopy over Traditional Abdominal Surgery (Laparotomy)
- Many diseases and abnormalities of the abdomen and pelvis can be safely treated using laparoscopy.
- Special laparoscopic instruments allow the surgeon to incise, biopsy, cauterize, or vaporize problem areas without the need for a large abdominal incision.
- Smaller incisions mean less discomfort and pain and reduced recovery time. Laparoscopic patients typically can return to normal activities after only two to three days of recovery.
Transvaginal Hydrolaparoscopy (THL): Improving on Conventional Laparoscopy
Transvaginal hydrolaparoscopy is a newer, less invasive procedure than conventional laparoscopy. It provides your fertility doctor an accurate view of the entire female reproductive tract. The THL procedure consists of making a small incision in the vagina directly behind the cervix. A narrow viewing instrument (endoscope) can be inserted through this incision to enter the pelvis directly behind the uterus.
Important Points about THL:
- Can be done with minimum, i.e., local, anesthesia.
- Requires no abdominal incisions.
- Uses water instead of carbon dioxide for abdominal distention.
- Studies show THL is better than conventional laparoscopy for visualizing most pelvic structures and diseases (except endometriosis).
- More cost-effective than conventional laparoscopy.
- Can be used as a preliminary screening procedure for infertility diagnosis and can help determine the need for conventional laparoscopy or more involved endoscopic procedures.
- Can help guide decisions about specific infertility treatment options.
SCRC founder and acclaimed fertility specialist, Dr. Mark Surrey, has reported excellent results using the THL procedure at SCRC’s fertility clinics.
What is Hysteroscopy?
Hysteroscopy is a surgical procedure used for looking within the uterine cavity (diagnostic hysteroscopy) and performing necessary sampling (biopsies) and corrections (operative hysteroscopy). It is not laparoscopy (laparoscopy uses abdominal incisions). However, hysteroscopy may be performed in conjunction with laparoscopy. The hysteroscopy procedure consists of gently dilating the canal of the cervix, and inserting a narrow viewing instrument (hysteroscope) directly through the canal into the uterine cavity. Hysteroscopy allows for direct and clear visualization of the cavity, and enables treatments of abnormalities such as polyps, fibroids, and projections of the uterine wall.
A Closer Look: Endoscopic Evaluation of the Lining of the Fallopian Tubes
Laparoscopy only allows your surgeon to see the exterior of the fallopian tubes. Blockages or disease of the interior of the fallopian tubes (known as the tubal mucosa) can be viewed with special instruments during procedures called salpingoscopy and falloposcopy.
How Can I Find Out More Information on SCRC’s Fertility Surgery Procedures?
Call us at (866) 312-0771 to speak to our specially-trained fertility consultants. They can give you further information about all the options we provide for fertility surgeries and schedule a consultation with your personal, dedicated SCRC fertility specialist.
