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A minimally invasive surgical technique that involves inserting a small camera near the belly button in order to look and possibly operate inside your abdomen. This is done under general anesthesia. Laparoscopy can be useful in evaluating or repairing the fallopian tubes, in removing ovarian cysts, in investigating or treating chronic pelvic pain, and to search for and remove endometriosis. In most cases, you should be able to go home the day of surgery and resume normal daily activities very quickly.
 
A laparoscopy is not recommended for every patient. However, on an individual basis, it may provide a diagnosis that would otherwise go undetected. Laparoscopy may also help other treatments work better.
 

 

Myomectomy

 
This refers to the removal of fibroids. Fibroids can be positioned in many locations: on the outside of the uterus, in the uterine muscle, and in the lining of the uterus. Removal of fibroids can be accomplished either by operating through the abdomen or by way of hysteroscopy, depending of the size and location of the fibroids.
 
Fibroids can cause a variety of symptoms including pain, abdominal pressure, bladder irritation, painful intercourse, abnormal bleeding, and difficulty becoming pregnant. When considering treatment for fibroids, it is very important to understand the limitations of each surgical method and to understand the goal of surgery, if necessary.
 
Fibroids can be removed by hysteroscopy, laparoscopy, or by an open incision in the belly (laparotomy). The choice of procedure depends on a patient’s symptoms and the size and location of fibroids.
 
 
Uterine Cavity After Hysteroscopic Removal of a Fibroid (Yellow-Tan Tissue on Bottom are remnants of the Fibroid)   Image of Fibroid Tumor Removed with Abdominal Surgery
 

Salpingectomy (removal of fallopian tube)

 
Sometimes one or both fallopian tubes may be damaged beyond repair. They may appear enlarged or swollen (hydrosalpinx) on ultrasound or on hysterosalpingogram, When this occurs, the damaged tube may actually be harmful to the development of a pregnancy and may reduce pregnancy rates with treatment, even through IVF. In this case, your physician may recommend removing the tube to increase your chances of becoming pregnant.
 
Sometimes your medical history may reveal a reason for a hydrosalpinx. In many women no identifiable risk factor is present. The presence of a hydrosalpinx may also increase your current and future risk for an ectopic pregnancy (tubal pregnancy) which can be dangerous. It is very important to discuss this with your physician.
 
 

Removal of Ovarian Cysts


Laparoscopic Picture Showing an Abnormal Cyst on the Ovary
Ovarian cysts are very common, especially in young women. Cysts that grow large often resolve on their own without requiring any treatment. Sometimes they may grow larger or persist and require surgery. The majority of cysts are benign. However, a small percentage of cysts may prove to be cancer. Surgical therapy is the only way to make an absolute diagnosis.
 
Cysts may be palpated on physical exam and may be more closely followed by ultrasound. When removal of a cyst is necessary, most can be removed be laparoscopy without the need for a large incision. The presence of a cyst is sometimes reflective of an underlying disorder such an endometriosis. If you have a cyst or have had cysts previously, your physician can discuss how they may affect your treatment.
 
 

Endometriosis


Laparoscopic Image Prior to Removal of Endometrioma on the Ovary
Endometriosis is common in reproductive age women. Endometriosis can make it harder for women to become pregnant. It can also cause chronic pain and painful intercourse. Surgical therapy combined with medical therapy can improve pain symptoms. In addition, surgical removal of endometriosis, especially when a cyst of endometriosis (endometrioma) forms, can help improve your chances of conceiving.
 
The treatment of endometriosis can be complicated. Your response to any one therapy may change over time. It is important to be treated by a specialist who can discuss both short term and long term therapy and tailor a treatment plans to your reproductive needs.