Minimally Invasive Surgery
Minimally invasive surgery avoids open surgery in favour of closed or localised surgery. The advantage to this is that it minimises hospital stay, shortens recovery periods and minimises scarring. Minimally invasive surgery favours the use of laparoscopic devices and remote-controlled instruments that do not give a direct view to the area. This is usually through tiny cameras attached to the instruments.
At CRGH we offer several types of minimally invasive surgery.
Trans-Vaginal Egg Collection
This involves the collecting of oocytes by using an ultrasound guided aspiration needle that pierces the vaginal wall and punctures the mature follicles. The contents are then aspirated and examined by the waiting embryologist.
Gamete Intra-fallopian Transfer (G.I.F.T.)
Oocytes are collected in the same manner as the trans-vaginal egg collection and then, once the patient is placed under a full general anaesthetic a laparoscopic incision is made and the fallopian tubes carefully assessed. The combined oocytes and prepared semen are then injected under laparoscopic guidance into the Fallopian tubes.
Laparoscopy and Dye
It checks that the Fallopian tubes are open and can also reveal other gynaecological conditions particularly endometriosis, fibroids, and adhesions (scar tissue) which can affect fertility.
A telescope is passed into the abdomen to view the womb, tubes and ovaries. A small cut (about 1 cm) is made in or below the navel to insert the telescope. To obtain a clear view, carbon dioxide gas is blown inside to lift the wall of the abdomen away from the internal organs. To see the delicate ends of the tubes it is usually necessary to pick them up using a second tiny instrument inserted low on the abdomen in the bikini line. At the end of the operation the gas is removed but may cause a feeling of bloating or discomfort in the ribs and shoulders afterwards. Usually the cut in the navel is closed by a single stitch.
Testicular Sperm Extraction (TESE)& Percutaneous Epididymal Sperm Aspiration (PESA)
Sperm is produced in the testicles and carried to the penis through the tubes which are known as the epididymis and the vas deferens.
When it is not possible for the sperm to travel beyond the testicles to reach the penis for ejaculation, then sperm can be retrieved by two different methods known as P.E.S.A or T.E.S.E.
P.E.S.A. is a minimally invasive technique which is used to extract sperm from the epididymis under local anaesthesia with a fine needle.
If sperm cannot be retrieved using this method then the patient may have to proceed to T.E.S.E. which is used to extract sperm from the testicles and can also be a relatively non-invasive procedure performed under local or general anaesthesia.
