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These are some of the operations used to treat infertility. First of all, there are three basic approaches to perform the surgery... Laparoscopy This is a same-day surgical procedure in which a telescope is inserted into the belly button and the pelvic organs are examined. Using the laser, electrocautery or other tools, endometriosis and/or scar tissue can be resected. This is usually done under general anesthesia, but in some instances is done under local anesthesia only. Hysteroscopy This is a same-day surgical procedure in which a telescope is inserted through the cervix into the uterus. The cavity of the uterus can then be examined, a procedures such as removal of a fibroid tumor, polyp or scar tissue can be performed. When done for diagnostic purposes, this can often be done in the office under local anesthesia Laparotomy This is the traditional approach to surgery in which an open incision is made in the abdomen and the procedure is performed through that incision. This allows for greater precision but has a substantially longer recovery time and more postoperative pain. Then there's the actual procedure performed. Here's a description of what can be done... Lysis of adhesions This refers to the cutting down or removal of scar tissue with scissors. laser or blunt instrument. Adhesions may result from a pelvic infection, endometriosis or prior surgery. Fulguration or excision of endometriosis Endometriosis is the presence of tissue similar to that found in the endometrium (the lining of the uterus) anywhere outside its normal location. These implants of endometriosis may be destroyed with an energy source such as a laser or electrocautery, or may be excised. Tuboplasty/salpingoplasty/fimbrioplasty These procedures are used to repair the fallopian tubes when they have become damaged. Today these procedures are usually performed by laparoscopy. Tubal reanastamosis (tubal reversal) This procedure is used to restore fertility to women who have undergone a tubal ligation. Typically it is done by a laparotomy, but some surgeons are able to do it through the laparoscope. Myomectomy Myomectomy refers to removal of a fibroid tumor, a benign smooth muscle tumor or the uterus. Fibroids are extremely common, and may be symptomatic. The procedure can be accomplished by all three techniques, although a laparoscopic myomectomy is questionable in women planning to have children. Their role in infertility is unclear.
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