Laparoscopy for Pelvic Adhesions
Pelvic adhesions are scar tissues that form as a response to tissue inflammation. Pelvic tissues become irritated and inflamed whenever they are damaged. It is a fundamental goal of all laparoscopic infertility surgery to reduce or prevent the formation of adhesions (scar tissue). Laparoscopy performed by an experienced fertility surgeon is usually able to significantly reduce (repair) pelvic adhesions.
Infertility surgery ideally employs “microsurgical techniques,” which include a variety of surgical measures designed to reduce postoperative adhesion formation. (1) There should be very gentle tissue handling, since crush injury to tissue results in damage and increases the likelihood of pelvic adhesions. (2) Any bleeding should be carefully controlled and blood within the pelvis should be washed out, since blood itself is highly irritating to the pelvic peritoneum that covers the pelvis. (3) Magnification should be used whenever useful at identifying appropriate tissue planes, since cutting into rather than around the pelvic tissues can cause damage to these tissues. (4) Tissue should be kept moist, which is far easier with laparoscopy than laparotomy, since dessication or drying of the tissues is irritating and often results in adhesion formation. (5) Infection should be prevented or avoided through meticulous sterile technique, use of laparoscopy when appropriate (since it is more difficult for infection to be introduced through the small incisions used during laparoscopy compared to the larger incisions used during laparotomy), and prophylactic antibiotics, since infection can rapidly destroy the delicate reproductive structures. (6) Cautery (used to control bleeding or destroy abnormal tissue by burning or searing) should be used as little as possible, since overuse of cautery results in ischemia and extensive tissue damage. (7) Thermal damage should be limited, which is uniquely possible with the use of the ultrapulse CO2 laser, since this laser is able to vaporize tissue with virtually no lateral thermal damage to the surrounding tissues.
Dr Eric Daiter at The NJ Center for Fertility and Reproductive Medicine, LLC has over 20 years experience with advanced operative laparoscopy and he has personally performed over a thousand laparoscopy surgeries using the ultrapulse CO2 laser for the treatment of pelvic adhesions. He would be happy to help you. Contact the office at 908 226 0250 for an appointment. Also, visit us on the web at http://www.ericdaiter.com http://www.drericdaitermd.com or http://www.infertilitytutorials.com