Modern aspects of development of endoscopic surgery in diagnostics and treatment of tubal peritoneal infertility
Introduction. Determination of the state of the fallopian tubes is one of the key tests in the examination of women, who suffer from infertility. Today the question of priority of certain methods is widely discussed in medical journals, but it can be noted that in the majority of centers hysterosalpingography (GHA) is currently preferred, which has become widespread. It is used for assessment of fallopian tubes. Obstruction of the fallopian tubes, defined as the absence of the entry of the contrast agent or dye into the abdominal cavity through the tubes when it is inserted into the uterine cavity, is observed in 20% of women with infertility. Almost all innovations and achievements in production of conductors, diagnostic and balloon catheters are reflected in the techniques proposed by different authors for transcatheter restoration of the proximal tubal permeability. Objective. To improve the procedure of laparoscopic operation, which will allow to conduct endovideoscopic examination in safer conditions without damage to the internal organs and absence of bleeding. Materials and methods. 420 patients with various forms of infertility and intrauterine pathology were hospitalized to the Department of Obstetrics and Gynecology and the Caspian Hospital Clinic. Patients were divided into 3 groups. The first group consisted of 212 women with tubal peritoneal infertility (TPB), the second group consisted of 113 patients with various forms of endometriosis, and the third group consisted of 95 women with polycystic ovary disease (BDPV). The proposed procedure of laparoscopic surgery helps to conduct endovideoscopic research in safer conditions. Results and discussion. When the Veresk’s needle and the first “blind” trocar were introduced according to the proposed procedure, the internal injuries and bleeding were not observed. Conclusions. We consider it appropriate to use the algorithm of differentiated approach to the choice of the method of surgery in benign intrauterine pathology. In case of good tolerability of diagnostic hysteroscopy, the patient can undergo surgical hysteroscopy according to S. Bettocchi method without anesthesia.