Ultrasonographically guided transvaginal hydrolaparoscopy

Abstract

Transvaginal hydrolaparoscopy was introduced as an outpatient procedure to examine the tubo-ovarian complex in infertile women. We evaluated ultrasonographically guided transvaginal hydrolaparoscopy (UTHL) as a modified technique for pelvic examination in 562 infertile women without overt evidence of pelvic pathology. Access to the abdominal cavity was observed by ultrasound and examination of the pelvic structures was done by hydrolaparoscopy using saline solution. Access was successful in all cases. No perforation of bowel or rectum was detected. Bilateral visualization of the tubo-ovarian complex was successful in 96% of women. Mild asymptomatic peri-ovarian adhesions were detected in 17% of the women, 4.9% had grade I endometriosis. There was unilateral tubal occlusion in 5%, and bilateral in 3.6%. In 13.9% elective operative laparoscopy for tubal obstruction and/or adhesions was recommended. UTHL is a safe outpatient procedure for examination of the tubo-ovarian complex. The use of ultrasound increases the rate of successful access to the pouch of Douglas and minimizes complications.

Assessment of β-human chorionic gonadotropin level as a reliable predictor of tubal patency confirmed with transvaginal ultrasound-guided selective salpingography (TVSSG) following conservative treatment of tubal pregnancy

“…If the results demonstrate tubal patency, there is a possibility of spontaneous pregnancy; in cases demonstrating obstruction in both tubes, the only treatment is the assisted reproduction with in vitro fertilization. Because there is little information about the fertility outcome of women treated conservatively with either MTX or expectant management, we present the subsequent reproductive performance in women treated according to our MTX and expectant management protocol [6][7][8][9].…”

Transvaginal hydrolaparoscopy

“…Our study shows a failure rate of 6.7%, which is comparable to known literature when THL is performed by experienced gynecologists , van Tetering et al 2007. Recent studies show that adding transabdominal ultrasound guidance to the introduction of the Veress needle can lead to a lower rate of failed procedures and complications (Sobek et al 2008, Ma et al 2015).…”

Transvaginal laparoscopic surgery for ovarian cysts

“…The 2 cases of access failure occurred toward the beginning of the study. Recently, transvaginal ultrasound-guided endoscopic colpotomy has been introduced to improve the rate of successful entry to the pelvic cavity [18,19].…”