There are two types of problems that women can have in their abdomen that can cause infertility and are difficult or impossible to detect without surgery. These two problems are endometriosis and pelvic adhesions (scar tissue). Fertility laparoscopy is a surgical procedure that allows a physician to see inside the abdomen and pelvis. Laparoscopy for fertility is concerned primarily with seeing the outside of the uterus, the fallopian tubes and the ovaries.
The laparoscope is a thin, fiber optic telescope. It is approximately the size of one of your fingers. The fiber optics allow light to be brought into the abdomen. Carbon dioxide (CO2) gas is put into the abdomen to separate the organs inside the abdominal cavity, making it easier for the physician to see the reproductive organs. The gas is removed at the end of the procedure. The laparoscope is inserted through the umbilicus (belly button) through a 10 mm incision. If needed, additional incisions can be made on the left and right at about the level of the pubic hair line. The additional incisions are about 5 mm and are used to introduce thin instruments that allow the surgeon to perform whatever operation is required.
The night before fertility laparoscopy
It is extremely important that do not eat or drink anything after 7:00 p.m. the night before surgery. Do not smoke or chew gum. It is okay to brush your teeth but do not swallow water. If you are currently taking medication, ask you doctor if you should stop taking it.
Check with your doctor to see if medication should be taken the night before the surgery in order to lessen the risk of blood clots forming during the surgery.
Nail polish, make-up and jewelry should be removed the night before surgery. Wear loose-fitting clothes.
Immediately before fertility laparoscopy
Please arrive at Naperville Fertility Center one hour before your procedure. After you check in at the Naperville Fertility Center front desk, you will be taken to a private admit / recovery room. You will be asked to remove all of your clothing (including underwear) and put on a patient gown. The nurse will complete a medical history and you will be asked to sign consent forms. One of our board certified anesthesiologists will also review your medical history and will then place an intravenous (IV) line in your arm. At this point, there is nothing but saline going into your veins, but later, the anesthesiologist will use this to administer medications to you.
Immediately prior to surgery, you will be asked to empty your bladder. Glasses, contact lenses, and jewelry (including piercings) should be removed. NFC has installed a locker in each admit / recovery room. Your valuables can be locked up and you can take the key with you or given to the person who accompanied you.
In the Operating Room
For fertility laparoscopy procedures, you will be taken to the operating room on a cart (essentially a bed on wheels). You will be asked to slide over to the cushioned operating room table. At this point, everyone in the operating room will be asked to stop what they are doing and perform a “time out”. During the time out, you will be asked to say your first and last name, date of birth and the type of surgery you are having. You will be asked to confirm whether or not you have any allergies. Then, the various members of the operating room will complete a checklist to make sure that all of the equipment for the surgery is present and working and to confirm that any medications are identified to the surgeon and labeled correctly. At the conclusion of the time out, the anesthesiologist will administer the medication to allow you to drift off to sleep for the surgery.
After fertility laparoscopy
After surgery, you will wake up in the same room that you were first admitted to prior to the surgery. You will be connected to monitors that allow the recovery room nursing staff to check your blood pressure, pulse and temperature frequently. The anesthesia medication will cause you to have limited short term memory. This means that you may not remember things you said or heard even a few minutes before. This is normal and will last only a short time.
There are different phases of recovery. In phase 1, the staff is making sure that you are stable and not having any problems after the surgery. You will not be allowed to have visitors in phase 1. In phase 2, you may have visitors and will be given something to eat and drink.
Your physician will discuss the findings with your family immediately after the surgical procedure is complete. The surgeon will have high resolution digital images to view on a tablet.
Medication will be available for pain or nausea. Medications will initially be administered though the IV until you are able to drink. Once you are able to drink, you can take oral medications.
You may notice a sore throat after the fertility laparoscopy. This is caused by irritation from the breathing tube placed in your throat (trachea) during anesthesia. It usually lasts for just a few days and can sometimes be helped by throat lozenges.
You will remain in the recovery area at NFC until you are determined stable and able to be discharged. For most patients, you can expect to stay in the recovery area for one to two hours. The nursing staff will be evaluating your
- vital signs to make sure you are stable
- ability to empty your bladder
- ability to tolerate eating and drinking without experiencing nausea or vomitting
Once you can demonstrate all of these things, you will be allowed to go home. You will be given prescription pain medication and nausea medication to take at home.
After Surgery Care and Follow up
You will have from 1 to 3 incisions depending on the type of procedure that was performed. The incision in your navel is 10 mm. Additional incisions may be from 5 to 10 mm. These incisions are closed with sutures under the skin which will dissolve. You do not have to have sutures removed later. You may notice a thread sticking out of the corner of the incision. This is normal.
The incisions will be covered with a bandage. You may remove the bandage after 24 hours. At this point, the incisions are water proof so you can shower and get them wet.
It is possible you may have drainage from these incisions for a day or two. It will be watery and pink-tinged. If needed, you may change the bandages if they become saturated.
You may experience some gas pains from residual carbon dioxide that may remain in your abdomen following the procedure. This pain is most commonly felt while sitting up or standing and feels like a sharp pain in your shoulder blade. If you experience this pain, try lying down. Pain medication may also be helpful. As the carbon dioxide is absorbed, this pain will go away, usually in a day or two.
You will experience pain from the incisions and you will need to use pain medications for a few days, sometimes longer
Unless you are told otherwise, you may eat or drink anything you like. Some patients will experience nausea from the anesthesia medications. If you do experience nausea which is not remedied by the prescription medication you were given, please call your doctor’s office and speak either with the physician or with the nurse.
For the first few days after the fertility laparoscopy, you can expect to feel sore and tired out. for the first 24 hours, you should just rest at home. You should not drive or operate machinery. You may increase your activity gradually after the first 24 hours.
For a week or two after surgery, you may notice that you tire out more easily when doing your normal activities. You also may notice less strength and endurance. When returning to work or activities, you may have to cut back at first. People will recover at different rates. Even if your friend was able to return to work in a few days, it may take you a longer period of time.
During fertility laparoscopy, a catheter is placed into your bladder to allow your urine to be emptied during the surgery. The catheter is usually removed before you wake up in the recovery room. It is common to experience some discomfort when urinating for the first day or two after surgery. If you experience burning or pain with urination after the first few days, or if you also have a fever, it is possible you might have a bladder infection. Please call your doctor to report these symptoms right away.
If you feel like you have a fever, please take your temperature. Notify your doctor’s office if your temperature is 101 degrees or higher. You should also call the doctor’s office if you notice increasing redness, swelling, pain or unusual drainage from your incisions.
Sexual activity may be resumed approximately two to three days following surgery unless you are told otherwise. However, if you have any pain, vaginal bleeding, or discharge, please do not resume sexual intercourse until these symptoms have subsided.
One day after the surgery will you receive a phone call from the nursing staff to make sure you are doing okay. At that time, you should set up an appointment to return to the doctor’s office for a postop visit and exam.