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Fallopian Tubes
and Ovaries

Laparoscopy Technique

Diagnostic Uses
of Laparoscopy

Demonstration
of Tubal Patency
via Laparoscopy

Laparoscopic Resection
of Unruptured
Ectopic Pregnancy

Ovarian Biopsy
via Laparoscopy

Electrocoagulation of
Endometriosis via
Laparoscopy

Lysis or Adhesions
via Laparoscopy

Control of Hemorrhage
During Laparoscopy

Fallopian Tube
Sterilization

Sterilization by
Electrocoagulation and
Division via Laparoscopy

Silastic Band Sterilization
via Laparoscopy

Hulka Clip Sterilization
via Laparoscopy

Sterilization by the
Pomeroy Operation

Sterilization by the
Modified Irving Technique

Sterilization by the
Minilaparotomy Technique

Sterilization - Ucheda Technique

Salpingectomy

Salpingo-oophorectomy

Fimbrioplasy

Tuboplasty -
Microresection
and Anastomosis
of the Fallopian Tube

Wedge Resection
of the Ovary

Torsion of the Ovary

Ovarian Cystectomy

Electrocoagulation of Endometriosis
via Laparoscopy

The purpose of electrocoagulating endometrial implants found at the time of laparoscopy is to destroy the implantation site. The purpose of the operation is to eliminate endometriosis.

Physiologic Changes.  Destruction of the endometrial implantation site in no way changes the potential of the mesothelium in the pelvis to form endometriosis. It is hoped that by eliminating the existing endometriosis, the surgeon can relieve the symptomatology (particularly in relation to infertility). In many cases, repeat surgery and treatment of endometriosis will be needed.

Points of Caution.  Extreme care must be exercised in fulgurating endometriosis in the pelvis to avoid electrocoagulation of adjacent vital structures, such as bowel or bladder.

Technique

This view through the laparoscope shows endometrial implants on the fundus of the uterus near the junction of the round ligament and Fallopian tube.

The 3-mm grasping forceps is inserted through the operating laparoscope. The forceps grasps the endometrial implant, which is thoroughly electrocoagulated. Care is taken to ensure that there is adequate insulation showing prior to performing the electrocoagulation.

The electrocoagulated site is inspected to rule out hemorrhage.

 

Copyright - all rights reserved / Clifford R. Wheeless, Jr., M.D. and Marcella L. Roenneburg, M.D.
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