Fertility and Reproductive Surgery
Surgery remains an important step in the treatment of infertility, particularly when the uterus is abnormally shaped, fibroids or polyps are present, or there is internal scarring.
Robotically Assisted Reproductive Surgery
Jones Institute doctors are the first in the Tidewater area to perform gynecologic laparoscopies with the assistance of the "da Vinci" robot at Sentara Norfolk General Hospital. Over the last two decades, minimally invasive surgery has become increasingly popular and has been demanded by both surgeons and patients.
Its benefits lie predominantly in reducing pain and providing a more rapid recovery for patients compared to traditional surgery. In addition to providing magnification, laparoscopy avoids tissue dying, foreign body contamination, tissue abrasion from packs and bleeding from an incision.
These factors improve healing and decrease postoperative complications. The use of a controlled robot has the potential to enhance surgical precision. Robot - assisted procedures do not differ from the standard laparoscopy, but they have a superior three - dimensional view of tissue as well as better maneuverability of surgical instruments.
Surgery can also be effective in reversing tubal ligation ( reopening "tied" tubes ). Whether or not tubal
reversal is possible depends upon many factors including patient age and how the tubes were " tied. " Not every surgery is reversible, but many are and acceptable pregnancy rates can occur. Tubal reversals in females over 37 years of age are rarely effective; therefore, IVF is usually recommended.
IVF has replaced many surgical treatments for infertility. For instance, although elaborate surgeries were devised to repair fallopian tubes damaged by infection, they are rarely done today. This is because the chance for pregnancy with one IVF cycle is higher than the chances after tubal surgery.
Endometriosis is another condition where IVF may be a better choice than surgery. Endometriosis is a common condition in which the type of tissue that lines the inside of the uterus implants outside the uterus in the pelvic area. It can cause pain and always seems to lower fertility.
Surgery may alleviate pain caused by endometriosis, but surgery for endometriosis rarely improves fertility. Women with the mildest degree of endometriosis can remain infertile when all the visible implants ( endometrial tissue ) have been removed. This fact is not widely accepted by many obstetrician / gynecologists and patients with endometriosis; consequently, patients should see a reproductive specialist as soon as diagnosed with endometriosis.
Surgery usually improves the chances for pregnancy if the uterus is deformed or if fibroids or polyps are present. Most surgeries can be performed laparoscopically, reducing the potential for scarring and decreasing recovery time. When the uterus is severely diseased or absent, a surrogate can carry the pregnancy to term.