Reproductive surgery specifically aimed at restoring or maintaining reproductive function. All the surgeons, those who specialize in reproductive endocrinology and infertility are specifically trained to be attentive to a woman’s future reproductive needs. The goal is to minimize the negative impact of surgery on the reproductive organs. Many minimally invasive procedures can be done in a day-surgery setting. Reproductive surgeons are specifically skilled at minimally invasive surgical techniques such as laparoscopy, hysteroscopy
Minimally invasive laparoscopic and hysteroscopy procedures are two procedures which are used to treat various reproductive disorders, including:
- Tubal reconstruction, repair, and tubal-ligation reversal
- Repair and reconstruction of intrauterine abnormalities such as scar tissue and congenital malformations
- Pelvic adhesions
- Removal of endometrial tissue due to dysfunctional bleeding that is not responsive to medical therapy
- Uterine fibroids
- Uterine polyps
- Ovarian cysts
- Ectopic pregnancy
Laparoscopy is a procedure used to examine the organs of the abdominal cavity. Laparoscopy utilizes a laparoscope, a thin flexible tube containing a video camera. The laparoscope is placed through a small incision in the abdomen and produces images that can be seen on a computer screen. The advantage of laparoscopy is that it allows a direct view of the abdominal and pelvic organs and structures without the need for major surgery. Operations can be performed through small (5-12mm) incisions which allows for quicker recovery, less pain, less scarring, and less blood loss.
Hysteroscopy is the visual examination of the canal of the cervix and interior of the uterus using a thin, lighted, flexible tube called a hysteroscope. The device is inserted through the vagina. Hysteroscopy may be used for both diagnostic and therapeutic purposes. Therapeutic maneuvers, such as taking a tissue sample (biopsy), removal of polyps or fibroid tumors, or preventing bleeding with cautery (destruction of tissue by electric current, freezing, heat, or chemicals) may be performed during a hysteroscopy procedure.
Female surgery treatments
Endometriosis. For women who are suffering from endometriosis, surgery can be done to remove or lessen, the amount of abnormal tissue in the pelvis.
This can be done through:
- Laparoscopy. The surgeon makes a tiny incision at the belly button and places a fiber-optic camera, allowing the doctor to visualize any scarring or abnormal tissue. Additional small incisions are made to introduce the instruments needed to perform the surgery
- Mini-laparotomy. The surgeon makes an incision in the abdominal wall to be able to reach the affected areas. Mini-laparotomy is performed through a small incision located just above the pubic bone. The surgeon explores the pelvis and corrects the problem.
- Laparotomy. The surgeon makes a larger incision, either just above the pubic bone or from the belly button down to the pubic hair area. Laparotomy may be needed for very severe scarring of the pelvis and is not an outpatient procedure.
Removal of Fibroid tumors
Approximately 30 percent of patients will have leiomyomata uteri (fibroid tumors). Fibroid tumors may be asymptomatic or may cause excessive uterine bleeding, recurrent miscarriages, pain, and pressure, or severe anemia. Adam & Eve excels in removing fibroid tumors via surgery.
Removal of Scar Tissue
Infertility or pelvic pain may be the result of scar tissue that has developed from previous abdominal or pelvic surgery, endometriosis or pelvic infections. Adhesiolysis (removal of scar tissue) is performed in Adam&Eve via laparoscopy. Scar tissue that has developed within the uterine cavity may also be removed via hysteroscopy performed as an outpatient.
Removal and Evaluation of Ovarian Cysts
Ovarian cysts are a common condition for patients during their reproductive years. A variety of non-malignant cysts may occur in ovarian tissue and, depending on the cyst symptomology and characteristics. Occasionally, removal of the cysts may only be accomplished via laparotomy, a major surgical procedure. However, in many cases, such cysts may be removed during an outpatient procedure via advanced laparoscopic surgery.
Patients who have had their fallopian tubes tied or cauterized may, for a variety of reasons, wish to restore their fertility. This may be accomplished by a procedure performed on the fallopian tubes termed tubal reanastomosis. Adam & Eve has been an expert in improving this procedure. In select cases, the success rate with this procedure has been excellent.
Correction of Abnormal Uterine Bleeding
In many instances, women experience excessive menstrual bleeding which can be debilitating. If this bleeding cannot be corrected hormonally, Adam&Eve reproductive surgeons are skilled in performing a procedure known as endometrial ablation. In this outpatient procedure, the uterine lining may be destroyed in a safe and rapid manner with little postoperative discomfort.
Male surgical treatments
Testicular biopsy is an in-office surgical procedure in which several small pieces of testicular tissue are removed and examined for sperm, which can be used in fertility procedures:
- Testicular sperm aspiration (TESA) involves a needle biopsy of the testicle in which a sample of tissue is taken directly from the testis and used to extract sperm for IVF or ICSI.
- Percutaneous sperm aspiration (PESA) involves a needle being inserted into the epididymis in an effort to locate and aspirate a pocket of sperm.
- Vasectomy reversal. A vasectomy reversal is often performed as an outpatient procedure and is done to reverse a previous vasectomy and restore the male’s ability to release sperm into his semen from the testicles.
Reproductive surgery is using surgery in the field of reproductive medicine. It can be used for contraception, e.g. in vasectomy, wherein the vasa deferentia of a man are severed but is also used plentifully in assisted reproductive technology.