Reproductive surgery has significantly evolved over the last 30 years. In the era before in vitro fertilization (IVF) resulted in high success rates, tubal surgery and repair of uterine anomalies were standard via an open abdominal incision (laparotomy), but typically did not yield high pregnancy rates or the desired outcome in most cases. The most common reasons were scar formation, severity of the disease, recurrence and significant tubal damage that could not be repaired. IVF has largely replaced tubal reconstructive surgery and laparoscopy has replaced laparotomy for most reproductive surgeries, except removal of fibroids (myomectomy), tubal reversal and some endometriosis cases.
Reproductive surgery includes clearing up scar tissue that may block the fallopian tubes and encase the ovaries (lysis of adhesions), opening blocked tubes (tuboplasty or neosalpingostomy), removal of fibroids (myomectomy), treatment of endometriosis, removal of ovarian cysts (ovarian cystectomy), treatment of problems associated with the endometrial cavity (hysteroscopic polypectomy, myomectomy, lysis of intrauterine adhesions, incision of uterine septum) and correction of pelvic anomalies.
Laparoscopy is a type of procedure that’s both diagnostic and therapeutic. It provides 100% accurate information about pelvic pathology and about the patency of the fallopian tubes. If there is pathology, the problem can be treated during the same procedure. Almost always, patients are able to go home the same day following such a minimally invasive surgery. Hysteroscopy is similar in technique and provides detailed information about the endometrial cavity and also offers both accurate diagnosis and the option of treatment during the same procedure.