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 discovered by laparoscopy and hysteroscopy, two procedures that provide a direct look at the pelvic organs. These procedures may be recommended as part of your infertility care, depending on your particular situation. Laparoscopy and hysteroscopy can be used for both diagnostic (looking only) and operative (treating) purposes.
Most of the surgical procedures are performed at Kingsbury Hospital which is located across the street from the Cape Fertility Clinic. With minimal invasive techniques, and therefore minimal scarring of the patient, the majority of surgical procedures can be performed. Office hysteroscopy and other minor theatre procedures are performed in the theatre at the Cape Fertility Clinic.
Laparoscopy is a common procedure performed by the gynaecologist. 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. Very often two additional incisions are made to thoroughly inspect the pelvic organs. The classical laparoscopy always requires general anaesthetic.
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 to allow 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. She is not allowed to drive. As a result of the anaesthetic the patient might feel tired and dizzy which is normal. Some feel 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.
Most fertility operations can be performed laparoscopically. The most common indications are:
Removal of fibroids
Removal of ovarian cysts or tumors
Ovarian capsule drilling
The Cape Fertility team is highly specialised in laparoscopic surgery and is a referral centre for advanced endoscopic procedures like severe endometriosis, removal of fibroids, tubal re-anastomosis and cervical cerclage.
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.
A diagnostic hysteroscopy can be performed at the procedure room of the Cape Fertility Clinic and can often be performed without an anesthetic. Many problems can be treated immediately (see and treat). Cape Fertility has a new hysteroscopy operating system (2019) for advanced onsite procedures.
The Cape Fertility team is highly specialised in advanced hysteroscopic surgery. We perform these procedures at Kingsbury hospital. The common indications are removal of fibroids, adhesions of the uterus, polyps and congenital abnormalities of the uterus.