Office laparoscopic assessment of female fertility
Hamid Arshat; Yuliawiratman; Asmar Suar Piliang
Malaysian Journal of Reproductive Health a Publication of the Reproductive Research Centre of the National Population and Family Development Board Malaysia 1(1): 46-54
1983
ISSN/ISBN: 0127-3213 PMID: 12279889 Document Number: 406133
This preliminary report details wxperience with office laparoscopy for female fertility assessment in 183 subjects at an urban Malaysian research clinic. Patients were admitted at about 8 AM and discharged at 3-4 PM after the procedure had been performed. Only 7.7% (14) of the subjects required inhalational anesthetic gases in addition to intravenous sedation and local anesthesia. The pick-up rate for pelvic abnormalities was about 22.4%. At laparoscopy, aspiration of ovarian cysts was carried out in 3 patients, lysis of adhesions in 6, salpingostomy in 3, and cautery of endometriotic spots in 30. 127 of the laparoscopies were performed by the consultant gynecologist, and 55 by medical officers. Minor difficulties occurred with 14 patients, including insufflation difficulty, and difficulty in trocar insertion and visualization. 1 uterine perforation occurred, and mild hemorrhage occurred in 2 patients after lysis and cautery procedures. 1 patient had respiratory depression after intravenous sedation. All complications were managed without hospital admission. It is suggested that all family planning clinics involved in fertility assessment and sterilization feature laparoscopy on an outpatient basis. However, proper training and adequate facilities for resuscitation are mandatory. More clinical triials are needed to discern the most suitable analgesia and anesthesia for office laparoscopy, including the possible use of acupuncture.