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Laparoscopy and
Infertility Surgery
Chapter 57
Jacqueline Kohl, MD, MPH
❍ When might diagnostic laparoscopy be indicated during an infertility workup?
In young women with a history of pelvic inflammatory disease, ectopic pregnancy, pelvic surgery, or chronic
pelvic pain.
❍ Which patients do not benefit from laparoscopic surgery for infertility?
Older women and those with multiple infertility factors: these patients are likely to do better with in vitro
fertilization (IVF).
❍ What types of pathology can be treated via laparoscopy?
Pelvic adhesions, endometriosis, endometrioma, mild hydrosalpinx, distal tubal occlusion, and leiomyoma.
❍ What are the relative contraindications to laparoscopic surgery?
Extremes of body weight, inflammatory bowel disease, presence of large abdominal mass, and advanced
intrauterine pregnancy.
❍ What is the size range of laparoscopes?
2 to 12 mm.
❍ What are the differences between unipolar and bipolar electrocoagulation systems?
In a unipolar system, the current passes from the generator through the instrument to a ground plate and then
back to the generator.
The bipolar system uses the two insulated jaws of the instrument to carry the current to and from the generator.
The tissue between the jaws completes the circuit.
❍ What is capacitive coupling?
The ability of two conductors to transmit or receive electrical flow while separated by an insulator. It is done in
unipolar coagulation.