Surgical Treatment

Laparoscopy provides the opportunity to examine a woman’s internal pelvic organs in a direct fashion, providing a great deal of information regarding the structural and functional relationships of the pelvic structures. This surgery is accomplished through the insertion of a long, thin lighted scope through a small incision (5-10 mm) in the belly-button. Other small incisions can be made to allow additional instruments to be placed in the abdomen so that manipulation of the structures and correction of abnormalities may occur. Due to the minimally invasive nature of laparoscopic procedures, they are usually done on an outpatient basis. However, many complex procedures can be accomplished laparoscopically, so they should never be considered as “minor surgery”.

Hysteroscopy is a surgical procedure that offers a direct view of the inside of the uterus and any abnormalities that may alter the inside of the endometrial cavity. It is accomplished by inserting a long, thin fiber-optic lighted tube through the cervix into the uterine cavity, while fluid expands the cavity to allow for visualization. Hysteroscopy allows for the precise localization of lesions and their surgical treatment with special instruments designed to be used through the hysteroscope.

Microsurgical Sterilization Reversal can be performed on women who have undergone tubal ligation but now desire further children. In many patients, the procedure can be performed on an outpatient basis. The procedure can be very successful for the appropriately selected patient. IVF can also be an effective option for these patients and, in many cases, the optimal therapy. Dr. Frattarelli is one of the most experienced in the world and will provide you with a thorough evaluation and recommend which is most appropriate for you.

The Fertility Institute of Hawaii recognizes that tubal reversals are an option for women.  Unfortunately, we generally do not see it as an optimum or cost efficient way to manage a previous surgery that was meant to be permanent. During your consultation and evaluation, our providers will discuss your treatment options to include tubal reversal based on your history and current assessment. For women who have had a tubal ligation, we often find that the present success rates of IVF and pregnancy far exceed the rate of pregnancy of a sterilization reversal.

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