Using specialized surgical treatments and instruments, our infertility specialists can examine and even operate on the reproductive organs without creating large incisions. Endoscopic surgery, which involves the use of very small cameras for visualization of the body’s internal structures, only requires a series of very tiny openings to allow doctors to perform many types of surgery. At Northern California Fertility Medical Center in Sacramento, we perform laparoscopy and hysteroscopy procedures for patients who have certain physical conditions, such as endometriosis or a tubal blockage.
Laparoscopy is a surgical method that allows doctors to access the exterior of the uterus, the fallopian tubes, and the ovaries. It can be used to diagnose and treat such conditions as tubal disease or blockage, ovarian cysts, pelvic adhesions, and endometriosis. Because only a few very small incisions are made, laparoscopic surgery is safer, less expensive, and requires less recovery time than a laparotomy (traditional open surgery of the abdomen).
Laparoscopy is generally performed while the patient is under general anesthesia. After making a small incision near the navel, the surgeon gently inflates the abdomen with carbon dioxide and places a laparoscope (a thin telescopic device with a camera and light source on the end) through the opening to visualize the internal organs. Additional small incisions may be made along the pubic line, through which very fine surgical instruments can be placed, allowing the surgeon to perform the necessary procedure.
Once the required operation has been completed, the abdomen is deflated and the incisions are closed. The patient will need to rest for a while in a recovery room — until the medical staff has determined that she is able to go home. The patient will have a period of limited activity after laparoscopy that will vary in length, depending on the type of procedure performed, but this time will be much shorter than it would be after traditional surgery.
While access to the ovaries, fallopian tubes, and outside of the uterus is possible through laparoscopy, a hysteroscopy, performed by our Sacramento-area physicians, is a procedure that allows doctors to view the interior of the uterus. It can be used to identify and treat such conditions as uterine polyps, fibroids, scarring, or a septum (separation that divides the uterus into two cavities instead of one).
Hysteroscopy can be performed with the patient under local, regional, or general anesthesia. The best option in a particular case will be determined by the surgeon based on such factors as the type of hysteroscopy being performed (diagnostic versus operative) and in what type of surgical suite the procedure will be taking place.
Instead of making incisions in the abdomen, the surgeon will introduce a hysteroscope (similar to a laparoscope) into the uterus through the opening in the cervix. This may require the cervix to be slightly dilated (opened) with a special instrument. The uterus will be carefully inflated with carbon dioxide to make visualization and surgical access easier. Once the operation is complete, the gas is removed. Since the instruments are inserted through the cervix, there are no incisions to close. Recovery time for hysteroscopy will depend on the particular condition being treated, but is significantly shorter than with traditional surgical treatments.
Women who have had tubal ligation surgery (commonly known as female sterilization or having one’s tubes “tied”) and would like to become pregnant again have the option of undergoing tubal ligation reversal, or tubal anastomosis. To learn about how this procedure is performed and who makes a good candidate, please visit our Tubal Ligation Reversal page.