WHAT HAPPENS DURING THESE PROCEDURES?
Hysteroscopy is the visualisation of the inside of your uterus, to establish that it is structurally normal and that there are no abnormal findings within the cavity, such as fibroids, polyps or adhesions. The investigation will usually allow the surgeon to see the openings to the Fallopian tubes at the top of the uterine cavity on each side (i.e. the tubal ostia), and a solution of saline is used to distend the cavity to give a clear picture. The findings are normally recorded on photographs, which can be viewed afterwards at your follow-up consultation.
Laparoscopy is performed by distending the abdomen with gas (to help obtain a good view) followed by the insertion of a fibre-optic telescope through the navel (umbilicus). The incisions that are made are very small and have been described as ‘key-hole’. This type of inspection allows the surgeon to view the abdominal cavity in general, and the pelvis in particular. The structures that we need to see include the uterus, fallopian tubes and ovaries. The surgeon is able to check whether the fallopian tubes are open and functioning normally by noting whether Methylene blue dye passes through the tubes into the pelvic cavity following injection of this blue solution through the cervix. Anomalies such as adhesions or blockages of the fallopian tubes will become apparent during this procedure, as will fibroids, ovarian cysts or endometriosis.
CAN PROBLEMS OR DEVIATIONS BE TREATED DURING THIS PROCEDURE?
As our gynaecologists have the ability to use lasers (or equivalent) any problems detected are normally dealt with at the time of operation.
CAN THE PROCEDURES BE DONE AT THE SAME TIME?
Hysteroscopy and Laparoscopy are commonly performed together thereby giving maximum information about the state of the pelvis.
WHAT CAN BE EXPECTED AFTER THE PROCEDURE?
When you wake up after the operation, you may have slight discomfort, but the doctor will usually put local anaesthetic into the small incisions made during the laparoscopy. In addition, the sutures used to close the incisions are usually hidden under the skin and do not need removal.
There may be slight bruising and discolouration of the abdominal wall on the day following the procedure but this will normally disappear and should not concern you.
Discomfort may be felt in your shoulders (particularly on the right-hand side) after the operation and this is due to gas being located under the diaphragm. Our surgeons make every effort to expel all the gas at the conclusion of the operation.
Your anaesthetist will manage pain relief.
You may have a slight blood loss which could last for a day or, in some cases, up to a week, but the latter is much more likely to be the case when surgical procedures are performed on the inside the uterus, such as removing fibroids. If the bleeding is not excessive, it should not cause you undue concern.
As a general anaesthetic is administered, you are advised to go home with an escort and not to drive yourself. It is wise to take things easy the day following your operation, prior to resuming your normal activities.
You are able to take a shower or bath the very next day. The small dressings need not necessarily be removed prior to this, although they can be removed a few days later since the small incisions tend to heal rapidly.
HOW SOON WILL I KNOW THE OUTCOME OF THE PROCEDURES?
You are usually seen by the surgeon prior to your discharge from hospital in order to be given a brief outline of what was found. Often you will not remember this encounter as the effects of the anaesthetic can be long lasting. Once you are home, you should telephone the secretary of Life Fertility Clinic to make a follow-up appointment (if this has not been arranged prior to your operation), so that a member of our team can discuss the findings of your operation with you, view the photographs and discuss further management.
WHAT ARE THE RISKS OF LAPAROSCOPY?
Like all surgical procedures there are risks associated with a laparoscopy, but these are thankfully very rare. They include internal haemorrhage, damage to vital organs such as blood vessels, bowel and urinary tract, as well as more minor problems such as bruising and wound infections.
For more information or queries regarding any of the services offered at Life Fertility Clinic, please contact us.