In the evaluation of infertility, identifying potential underlying causes is important in order to guide an appropriate and individualized treatment strategy. In cases where endometriosis is suspected, direct visualization of the pelvic cavity can provide valuable diagnostic information.
Laparoscopy allows a detailed assessment of the uterus, fallopian tubes, ovaries, and surrounding pelvic structures. It is considered the reference standard for the diagnosis of endometriosis and allows simultaneous surgical treatment when clinically indicated.
When combined with chromopertubation, laparoscopy also enables the assessment of fallopian tube patency, providing relevant information for further fertility management.
Before the procedure, patients receive a detailed preoperative consultation, including information about the intervention and a discussion of potential risks.
Laparoscopy is performed under general anesthesia. A small incision is made near the umbilicus, and carbon dioxide is introduced to gently insufflate the abdominal cavity, creating adequate working space. A laparoscopic camera is then inserted to provide real-time visualization of the pelvic organs.
For assessment of fallopian tube patency, a colored dye is injected through the cervix (chromopertubation). The passage of dye through the tubes and its spill into the abdominal cavity confirms tubal patency.
At the end of the procedure, the gas is released and the small skin incisions are closed with sutures. Laparoscopy is minimally invasive, and patients are usually discharged the same day or after a short observation period.
Traditional methods for assessing tubal patency, such as hysterosalpingography (HSG) and sonohysterography, involve the introduction of a contrast medium through the cervix into the uterine cavity. The distribution of the contrast through the fallopian tubes is then evaluated using X-ray or ultrasound imaging.
In contrast, laparoscopic chromopertubation allows direct visualization of the pelvic organs and provides a detailed assessment of tubal patency. It also enables the identification and, when clinically indicated, simultaneous treatment of associated pelvic pathology, such as endometriosis or adhesions.
Non-invasive methods, such as HSG or sonohysterography, are commonly used as first-line diagnostic tools; however, their diagnostic accuracy may vary depending on the clinical context and the type of underlying pathology.
The choice of diagnostic method is individualized and based on the patient’s medical history, symptoms, and overall fertility evaluation.
Dr. Roukoudis has trained and worked in laparoscopic surgery in Germany and Spain, performing minimally invasive gynecological procedures as part of his clinical practice.
He is certified in minimally invasive surgery (MIC I) in Germany, reflecting structured training in laparoscopic techniques.