Reproductive Surgery
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A complete examination of a woman’s internal pelvic structures can provide important information regarding infertility and common gynaecologic disorders. Frequently, problems that cannot be discovered by a physical examination or ultrasound can be identified through laparoscopy and hysteroscopy, two procedures that offer a direct view of the pelvic organs. These procedures may be recommended as part of your infertility care, depending on your situation. Laparoscopy and hysteroscopy can be used for both diagnostic (observation only) and operative (treatment) purposes.

Most surgical procedures are performed at Kingsbury Hospital, located across the street from Cape Fertility. With minimally invasive techniques, resulting in minimal scarring for the patient, most surgical procedures can be performed. Office hysteroscopy and other minor theatre procedures are conducted at Cape Fertility.

What is Laparoscopy?

Laparoscopy is a common procedure performed by gynaecologists. The two most common reasons why gynaecologists perform laparoscopies are for the diagnosis of infertility and pelvic pain. The classical laparoscopy is performed through a one-centimetre incision in the navel. Often, two additional incisions are made to thoroughly inspect the pelvic organs. The classical laparoscopy always requires general anaesthesia.

Carbon dioxide gas is used to expand the abdominal cavity to provide better viewing. The doctor will then insert a scope through a small incision inside the navel to view the outside of the uterus, ovaries, and fallopian tubes. Often, a second and third incision is made just below the pubic hairline through which instruments are inserted to manipulate the organs, allowing the surgeon to examine different angles. If found, endometriosis and adhesions may be removed during this surgery. This is called an operative laparoscopy.

In the recovery room, the attending nurse will observe the patient until she is conscious, and then the patient will return to her room. She is usually discharged on the same day and is not allowed to drive. As a result of the anaesthesia, the patient might feel tired and dizzy, which is normal. Some may experience shoulder pain for the first 24 hours after the operation. Painkillers are provided for the first few days. The recovery time is usually one week.

What are the reasons to perform a laparoscopy?

Most fertility operations can be performed laparoscopically. The most common indications are:

  • Diagnostic laparoscopy
  • Pelvic endometriosis
  • Tubal surgery
  • Removal of fibroids
  • Removal of ovarian cysts or tumours
  • Ovarian capsule drilling
  • Laparoscopic cerclage
  • Advanced laparoscopy

The Cape Fertility team is highly specialised in laparoscopic surgery and is a referral centre for advanced endoscopic procedures such as severe endometriosis, removal of fibroids, tubal re-anastomosis, and cervical cerclage.

What is Hysteroscopy?

Hysteroscopy is a useful procedure to evaluate women with infertility and recurrent miscarriage. Diagnostic hysteroscopy is used to examine the uterine cavity and is helpful in diagnosing abnormal uterine conditions such as fibroids protruding into the uterine cavity, adhesions, polyps, and congenital malformations.

Office Hysteroscopy

A diagnostic hysteroscopy can be performed in the procedure room of the Cape Fertility and can often be done without anaesthesia. Many problems can be treated immediately (see and treat). Cape Fertility has a new hysteroscopy operating system (2019) for advanced onsite procedures.

Operative Hysteroscopy

The Cape Fertility team is highly specialised in advanced hysteroscopic surgery. We perform these procedures at Kingsbury Hospital. The common indications are the removal of fibroids, adhesions of the uterus, polyps, and congenital abnormalities of the uterus.