Endoscopic Procedures

Endoscopy is the general name of applications aimed at imaging the insides of the body and hollow organs with special devices equipped with light and cameras. Endoscopic applications in in vitro fertilization treatment are divided into two main categories: laparoscopy and listeroscopy. Laparoscopy involves making small incisions in the woman's abdomen during in vitro fertilization treatment and inserting a thin camera and other surgical instruments into the internal organs. With this method, the ovaries, uterus and surrounding tissues can be examined in detail. Listeroscopy provides information about the inner surface of the uterus and the condition of the tubes by inserting a thin camera into the uterus and plays an important role in in vitro fertilization treatment.

Endoscopic Procedures at Liv Hospital

Liv Hospital is a healthcare institution that successfully performs endoscopic procedures in in vitro fertilization treatment and other gynecological health issues. Expert gynecologists and surgical team manage patients' treatment processes in the most effective and comfortable way by using endoscopic methods such as laparoscopy and listeroscopy. Endoscopic procedures performed at Liv Hospital offer patients a solution-oriented service in gynecological health issues by offering faster recovery, minimally invasive approach and sensitive surgery advantages.

Less Pain and Risk of Infection

While Laparoscopy is used for observation of the inside of the abdomen and related surgical applications, Hysteroscopy is used for observation of the inside of the uterus and surgical applications within this organ. Especially in operative applications, it has advantages compared to open surgeries, such as the risk of damage to tissues and organs, the risk of infection, ease of procedure, less post-procedure pain, and no surgical scars. However, in special cases such as the presence of large and numerous myomas and ovarian cancer, open surgeries are still preferred.

Laparoscopy

Laparoscopy procedure is divided into diagnostic and operative (surgical) according to the application indication. The procedure is performed in a sterile operating room environment and under general anesthesia, as small holes must be opened in the abdomen and complications that may arise during the procedure can be dealt with immediately.

Same Day Discharge

For the procedure, first of all, the abdomen is inflated with carbon dioxide gas, which is inserted into the abdominal cavity with a thin needle through the belly button. Afterwards, a small incision (about 1 cm) is made under the belly button and a trocar tube is placed, which allows the camera imaging device to enter the abdomen. The condition of the organs is examined with a lighted camera device that passes through this tube and is delivered to the abdominal cavity.

If an operative procedure is planned, 3-4 more trocar tubes can be placed to place the instruments required for the procedure. At the end of the examination or operation, the devices are removed and the gas in the abdomen is completely evacuated, and the procedure is completed by stitching the incisions. The hospital stay after laparoscopy is quite short and discharge can often be made on the same day. The patient can return to normal life the next day in diagnostic applications and within 7-15 days in operative applications.

Diagnostic Laparoscopy

In infertile patients whose examination and ultrasound findings and HSG do not show any abnormalities, no different findings are usually observed in diagnostic laparoscopy.

It is very useful in diagnosing the following problems:

• intra-abdominal adhesions
• blockage in the tubes
• Suspicion of endometriosis
• Chronic pelvic (area between the pelvic bones) pain
• pelvic masses
• anatomical abnormalities

Operative (Surgical) Laparoscopy

Laparoscopic operations are successfully performed for treatment purposes in infertile patients in the following indications:

•  
• Opening of intra-abdominal adhesions (Adhesiolysis)
• Endometriosis (cauterization or excision depending on degree)
• Aspiration of ovarian cysts
• Removal of myomas (Myomectomy)
• Endometrioma (Chocolate cyst)
• Ectopic pregnancy (Salpingostomy)
• Ovarian torsion (Ovarian rotation)
• Tube removal (Salpingectomy)
• Opening tied or blocked tubes (Tubal reanastomosis)
• Uterine perforation (Uterine perforation)
• Anatomical disorders (Uterus suspension)

Hysteroscopy

Hysteroscopy procedure is divided into two as diagnostic and operative (surgical) according to the application indication. While diagnostic hysteroscopy (also known as office hysteroscopy) can be performed under local anesthesia in the office setting, operative procedures are preferred in the operating room environment and under general or spinal anesthesia. The procedure is performed a few days after the end of menstrual bleeding to ensure that the patient is not pregnant and because the inner wall of the uterus (endometrium) will be quite thin and it will be easier to detect possible abnormalities.

Since the imaging device (hysteroscope) used for the procedure is quite thin (5 mm) and is entered through the cervix, it is generally a painless procedure. However, sometimes it may be necessary to use medications that relax the cervix to facilitate the transition. Again, for this purpose, long thin rods called spark plugs can be used during the process. The uterus is reached by entering the cervix of the patient in the gynecological examination position with the hysteroscope device, and imaging and examination are performed after the uterus is expanded sufficiently with the carbon dioxide or liquid injected. At the end of the examination, the procedure is completed after the gas or liquid in the uterus is evacuated.

Return to Daily Life in a Short Time

Discharge time after hysteroscopy is quite short. The patient can be discharged within 1-2 hours in diagnostic applications, and usually the next day in operative applications, and can return to normal life.

Diagnostic Hysteroscopy

It is applied for the following indications in order to detect a possible abnormality in the uterus;

•  
• Excessive or irregular menstrual bleeding
• recurrent miscarriages
• Intrauterine adhesions (Asherman syndrome-uterine synechiae)
• Suspicion of intrauterine polyp and myoma in ultrasound examination
• Repeated unsuccessful in vitro fertilization attempts
• Removal of intrauterine spiral or foreign material
• Examination of the uterine canal
•  

Operative (Surgical) Hysteroscopy

It is applied to correct the following intrauterine abnormalities determined by diagnostic examinations (HSG, H/S, ultrasound).