Laparoscopy can be used to investigate the cause for problems such as chronic pelvic pain as well as to undertake almost any gynaecological operation.
Laparoscopy as an investigative tool:
- Investigation for chronic pelvic pain: Laparoscopy is the gold-standard approach for thoroughly evaluating the pelvis when a cause for pain is being sought. It allows the identification of conditions such as endometriosis and pelvic adhesions that may not show up with ultrasound scanning or other imaging tests like CT or MRI.
- Assessment of infertility and tubal patency: Laparoscopy provides the most comprehensive approach for systematically assessing the pelvis and evaluating tubal patency in cases of infertility.
Laparoscopy as a treatment tool:
- Endometriosis: Endometriotic deposits can be cut away using fine scissors or they can be burnt using electrical energy known as diathermy.
- Adhesions: Scarring brought about by endometriosis or previous pelvic infection can be broken down (referred to as adhesiolysis) using laparoscopy.
- Ovarian cysts: Most forms of ovarian cysts can be removed using laparoscopy.
- Myomectomy: This refers to the removal of fibroids from the womb.
- Hysterectomy: The womb can be removed using laparoscopy, for instance, in women with very heavy periods who have completed their family.
- Oophorectomy: Either one or both ovaries can be removed.
- Salpingo-oophorectomy: Removal of ovaries in addition to the Fallopian tubes can be performed by laparoscopy. One instance in which salpingo-oophorectomy may be advised is in women who carry a mutation in the BRCA1/2 gene since this increases the risk of developing ovarian cancer.
- Ectopic pregnancy: This is a pregnancy located outside of the womb, most often in the Fallopian tube. These pregnancies are very risky since they can cause heavy internal bleeding and tubal rupture. Laparoscopy can be used to either remove the tube with the pregnancy inside it or sometimes, if it is feasible, to remove only the pregnancy.
- Tubal surgery: Laparoscopy can be used to correct blocked tubes or to remove tubes that are swollen and too badly damaged to be repaired.