Micro laparoscopy is a minimally invasive diagnostic surgical procedure. Laparoscopy enables the surgeon or a gynecologist to directly view the organs of the abdomen and pelvis. Laparoscopy minimizes hospital stay after surgery and recovery period too. Laparoscope is an instrument in the shape of a miniature telescope with a fiber optic system. The laparoscope is a sterile surgical instrument, which has special optics that allows small amounts of light to be transmitted effectively. A laparoscopy involves two cuts approximately 5 -10 cm long. The first cut is below the navel. A hollow needle is inserted. Carbon dioxide gas is pumped into the abdomen through this channel in the laparoscope. This is done to create a space within which the surgeon can look or operate.
The laparoscope is inserted through a second small cut made on the abdomen. The exact position depends upon the procedure that is being conducted. The laparoscope can be moved around within the abdominal or pelvic cavity to give several different views to the operating surgeon. At the end of the procedure, the instruments are removed and the carbon dioxide gas is allowed to escape and the cuts closed with stitches.
Oviduct blockage is the blockage in one or both microscopic fallopian tubes that allow a woman's egg to pass from her ovaries to her uterus. The blockage is an impediment for the egg to migrate, implant and begin pregnancy. The result is infertility. In rare cases, even if pregnancy occurs it can be dangerous, if not treated immediately.
Diagnosing oviduct blockage
Laparoscopic chromotubation: Usually done after sedating with a mild anesthetic, laparoscopy involves making a very small incision in the belly button and near the pubic bone area; a small camera helps view the tubes. Laparoscopy helps detect endometriosis, adhesions, and ovarian cysts and also check the tubes.
Chromotubation involves infusing diluted methylene blue dye solution into the uterine and tubal lumen. If the tubes are not blocked, the dye should come out of the ends of the tubes into the peritoneal (abdomen) cavity. This test is considered the most reliable way to determine oviduct blockages.
Both laparoscopic chromotubation and Hysterosalpingogram can sometimes open a blocked tube; hence these procedures can be both diagnostic and therapeutic. The rate of fertility is likely to improve after the procedure.
Falloscopy: The newest form of endoscopic examination, falloscopy is helpful to look inside the fallopian tubes. Using a catheter-based system, a flexible tube is inserted through the vagina and cervix which threads through one of the fallopian tube. Very similar to hysterosalpingogram, it allows viewing of tubal walls and checks if it is healthy and also detects obstruction, if any.
Sonohysterography: This is a non-invasive procedure wherein fluid is injected through the cervix into the uterus, and ultrasound imaging is used to determine if any abnormality is present. The procedure is extremely helpful in detecting underlying cause of many problems such as abnormal uterine bleeding, infertility and repeated miscarriage. Like the other diagnostic procedures, sonohysterography is done when the woman is not having her menstrual cycle.
Oviduct blockage treatment
The goal of treating oviduct blockages is to unblock fallopian tubes and increase the chances for a successful pregnancy. Surgical procedures are the primary treatment option to open blocked oviducts. If needed, doctors will use more than one procedure to treat oviduct blockage. Take a look at the various surgical and non-surgical options available today to treat this particular condition.
Laparoscopy: To treat oviduct blockages, laparoscopy is widely preferred. It involves inserting the scope into the abdomen and cutting away scar tissue which blocks the tubes and is a result of infection and/or endometriosis, primary causes for oviduct blockages. It helps in unblocking the oviducts and allows the eggs and sperm to meet and facilitates the egg to become fertilized.
Recanalization: A tiny wire is inserted into the tube to remove the blockage.
Salpingectomy: It involves removing a blocked fallopian tube or sealing it in order to maximize the functioning of the second, unblocked tube.
Tubal Reanastomosis: This is also a laparoscopic procedure in which small incisions are made through the abdomen. The blocked portion of the oviducts or fallopian tube is cut away and the healthy sections of the tube are connected. It is followed by a procedure called Salpingostomy to create a new opening in the tube close to the ovary.
Fimbrioplasty: This plastic surgery that facilitates to reshape ends of fallopian tubes closed off by scar tissue or some other blockage.
Tubal Cannulation: Is a non-surgical option which involves clearing blockages with the use of a catheter, or Cannula that is inserted through the uterus into the fallopian tube.
An inflamed appendix leads to a condition of appendicitis. In this condition, the opening of the appendix into the cecum is blocked. Mucus or stool can be the causes for the blockage. A blood clot or carcinoid tumor may also be a cause for the blockage of the appendiceal orifice. In some cases, appendicitis follows a gastrointestinal viral infection. The inflammation causes reduced blood supply to the appendix thereby diminishing its ability to fight infection. Inflammation and infection can lead to a rupture of the appendix thereby spreading the infection to the entire abdominal area. Perforation of the appendix usually warrants immediate surgery. If the infection is allowed to enter other parts of the body, it can be life-threatening. Another fallout of appendicitis is that the contents of the intestine are blocked from passing. This leads to abdominal distension with nausea and vomiting. In few cases, the body is able to resolve the inflammation and infection with antibiotics and care. This usually happens when the appendicitis is noticed and diagnosed at a very early stage.
Symptoms of appendicitis are abdominal pain that is diffused and not localized. The patient might have elevated body temperature with tenderness in the lower right abdomen, if palpated. When the appendiceal inflammation increases, the pain is clearly localized to a single area - between the front of the right hip bone and the belly button. Early symptoms of appendicitis are often easily mistaken for gastroenteritis. Children may have fewer symptoms thereby making diagnosis more difficult. Appendicitis is first diagnosed with a thorough physical examination. Abdominal scans are useful in detecting the cause of blockage. A blood test of a person suffering from appendicitis will reveal abnormal white blood count. But it cannot be taken as the only sign of appendicitis. A CT Scan can help reveal the area of the appendix that is affected.
With traditional appendectomy, the surgeon enters the abdomen through a 3 inch long incision. The appendix is removed by freeing it from the attachment to the abdomen and colon. Pus will need to be drained in case of an abscess. Laparoscopy is now regularly used to remove an inflamed appendix. A small fiber optic tube with camera is inserted through one or two small punctures made on the abdominal wall. Tiny instruments are passed through the other abdominal incisions to remove the appendix. Laparoscopy allows a surgeon to view the appendix and other abdominal organs. A decision can then be made whether the appendix needs to be removed at all. A clear diagnosis is possible with laparoscopy on doubtful cases of appendicitis. Laparoscopic appendix removal allows faster recovery and lesser scarring.
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Bibliography / Reference
Collection of Pages - Last revised Date: June 17, 2019