A comparative interventional study of single port and double port methods in diagnostic laparoscopy for evaluation of cases of infertility in department of obstetrics and gynaecology, SMS medical college and hospital, Jaipur

Abstract

Introduction: Infertility is defined as incapability of a couple to achieve conception after a year of unprotected intercourse. Diagnostic laparoscopy is gold standard technique for evaluating such cases. The view obtained at laparoscopy is better than at the time of laparotomy. This is called "Panoramic view". Introducing only one port for entry of camera vis a vis one extra ancillary port for diagnostic purpose for manipulating abdomino-pelvic structures has been recommended by several authors but authentic studies are lacking Aims and Objectives: To compare single puncture with double puncture diagnostic laparoscopic technique and to evaluate benefits and side effects of a second puncture in infertile women. Materials and Methods: This study was a hospital based comparative type of interventional study conducted in the Department of Obstetrics & Gynaecology, S.M.S. Medical College, Jaipur from March 2016 to July 2017. All infertile women (both primary and secondary) admitted and posted for diagnostic laparoscopy by single and double puncture method in, of age between 20-40 years were enrolled in the study. Results: In majority of patients (80%) by single port, there was incomplete visualisation of both fallopian tubes, ovaries, pouch of douglas, spill of dyes. Full length of both tubes till fimbrial end, complete evaluation of both ovaries and their pathology was not possible even with proper technique, bowel preparation and Trendelenburg position. Using second port, it was possible to evaluate complete pelvic structures and their pathologies, bilateral or unilateral spill of dye, pouch of douglas by manipulation of intestinal loops and holding the tubes. Conclusion:Approximately in 90% of the patients the operative surgeon could make out pathology and get a proper look at the structures along with therapeutic correction of pathologies in same setting without causing extra discomfort and postoperative pain and complication in comparison with single port technique.