Diagnostic laparoscopy with infertility related corrective surgery at Shivdikar Human Reproduction & Fertility Centre
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Diagnostic laparoscopy with infertility related corrective surgery at Shivdikar Human Reproduction & Fertility Centre

Laparoscopy is a surgical procedure in which a telescope is inserted inside the abdomen through a small incision below the navel, so that the doctor can have a look at the pelvic organs through the video visualization & simultaneous recording of the procedure in the infertile woman. A laparoscopy can lead to the diagnosis of many problems which cause infertility including damaged tubes, endometriosis, adhesions and tuberculosis and all these problems can be treated through the laparoscope at the same time that the diagnosis is made.

 
Diagnosis of The Tubes:
whether it is normal, healthy or pathological like hydrosalpinges or pyosalpinx or hematosalpinx or beaded appearance suggestive of tuberculosis of the fallopian tube.
 
Diagnosis of Uterus:
enlarged uterus is suggestive of uterine fibroid. Fibroid more than 3cm should be removed off through laparoscopy, fibroid which compressing the endometrium into the uterine cavity can be removed through laparoscopy.
 
Diagnosis of Ovaries:
unilateral or bilateral ovarian enlargement due to the presence of ovarian cyst consisting of physiological fluid, pus, blood of a chocolate cyst which can be drained by laparoscopy.
 
PCOD:
Bilateral pearly white glistening ovary with 3 times enlarged size is suggestive of PCOD (Polycystic ovary) first described by Stein and Leventhan in 1935 in Australia. Modern trend of treating PCOD is to puncture at different places (5-6 punctures) in each ovaries with or without electro-cauterization.

In cases of Ovarian adhesions, the adhesions can be removed by laparoscopy and ovaries can be brought down into the pouch of douglas to make the ovaries accessible transvaginally. Trans vaginal access of the ovaries are important for Ovum Pick Up for IVF.
 
Endometriosis :
Endometriosis is the term used when the endometrium is present outside the uterine cavity, it can be present on the fallopian tube, on the ovary behind the uterus and on the support of uterus called Utero-sacral ligament. In elderly female, can be present in the Myometrium called Adenomyosis of the uterus. It alters the normal physiological menstrual cycle, hormonal pattern. In early phase, treatment of endometriosis may not be required but in later part, either surgical or medical line of treatment is required. Most of the endometriotic patients may need Assisted Reproduction Technology after the correction of endometriosis like Antagonist, dianabol, oral contraceptives & surgical treatment like fulguration of endometriotic area and drainage of chocolate cyst.
 



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Dr. Ashok H. Shivdikar
Shivdikar Hospital & Fertility clinic
Shivdikar building No. 28-A, J.B. Road,
Opp. Shirodkar Market, Parel (East), Mumbai- 400 012

 
 
     
          
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