Diagnostic Laparoscopy for Infertility

What is a diagnostic laparoscopy?

A diagnostic laparoscopy is a procedure in which your healthcare provider uses a laparoscope to look at the organs and tissues inside your abdomen. A laparoscope is a long, thin tube with a light and tiny camera.

When is it used?

You may have a laparoscopy if you have been unable to become pregnant.

Alternatives to this procedure include:

• having an ultrasound scan, a scan with high-frequency sound waves
• having a CT scan or MRI
• a special type of X-ray, such as a hysterosalpingogram (putting dye into the uterus so it can be seen on an X-ray film)
• having a hysteroscopy (putting a scope into the vagina and through the cervix to examine the inside of the uterus)
• having more extensive abdominal surgery
• choosing not to have treatment.

You should ask your healthcare provider about these choices.

How do I prepare for a diagnostic laparoscopy?

Plan for your care and recovery after the operation. Allow for time to rest and try to find other people to help you with your day-to-day duties.

Follow your healthcare provider's instructions about not smoking before and after the procedure. Smokers heal more slowly after surgery. They are also more likely to have breathing problems during surgery. For this reason, if you are a smoker, you should quit at least 2 weeks before the procedure. It is best to quit 6 to 8 weeks before surgery. Also, your wounds will heal much better if you do not smoke after the surgery.

Follow any other instructions your provider gives you. If you are to have general anesthesia, eat a light meal, such as soup or salad, the night before the procedure. Do not eat or drink anything after midnight or the morning before the procedure. Do not even drink coffee, tea, or water.

What happens during the procedure?

You are given either a local anesthetic and sedative or a general anesthetic to prevent pain.

Your abdominal cavity is inflated with carbon dioxide gas. This helps your healthcare provider see your organs. Your provider makes a small cut in or just below your bellybutton, puts a laparoscope through this cut, and puts another tool through a second small cut in the lower abdomen. The laparoscope is used to look at your pelvic organs and tissues. If your provider finds a growth that should not be there, the other tool may be used to move organs around, get a better view of your organs, or take a sample of the growth or remove it. The sample is sent to the lab for tests.

When finished, your provider releases most of the gas through the tube of the laparoscope, removes the scope and any other tools, and sews up the cuts.

What happens after the procedure?

You may stay in the hospital several hours or overnight to recover. The anesthetic may cause sleepiness or grogginess for a while. You may have some shoulder pain, feel bloated, or find a change in bowel habits for a few days. You may not be able to urinate right away and may have a catheter (a small tube) placed into your bladder through the urethra (the tube from the bladder to the outside).

You should avoid heavy activity such as lifting. You should ask your healthcare provider how much you should lift, what other steps you should take, and when you should come back for a checkup.

What are the benefits of this procedure?

This minor surgical procedure may help the healthcare provider make a more accurate diagnosis about the cause of infertility. Possible causes include pelvic adhesions or endometriosis. Your provider may be able to treat the cause during the laparoscopy. Your stay at the hospital and time needed to recover will be much shorter than with more expensive and extensive abdominal surgery. You are also less likely to develop a type of scar tissue called adhesions in the abdomen or pelvis, or other complications.

What are the risks associated with this procedure?

• There are some risks when you have general anesthesia. Discuss these risks with your healthcare provider.
• The abdominal organs, glands, or blood vessels may be damaged. You may need abdominal surgery to repair them at the time of the laparoscopy.
• The lining of the abdominal wall may become inflamed.
• You may have infection or bleeding.
• You may have some pain after the procedure.
• Your doctor may not find the cause of your infertility.

You should ask your healthcare provider how these risks apply to you.

When should I call my healthcare provider?

Call your provider right away if:

• You develop a fever over 100°F (37.8°C).
• You have redness, swelling, pain, or drainage from the incisions.
• You become dizzy and faint.
• You have chest pain.
• You have nausea and vomiting.
• You become short of breath.
• You have abdominal pain or swelling that gets worse.

Call during office hours if:

• You have questions about the procedure or its result.
• You want to make another appointment.