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An alternative treatment option uses laparoscopy to treat patients with PCOD. During operative laparoscopy, a laser or cautery is used to drill multiple holes through the thickened ovarian capsule. This procedure is called laparoscopic ovarian cauterisation or ovarian drilling or LEOS.

An alternative treatment option uses laparoscopy to treat patients with PCOD. During operative laparoscopy, a laser or cautery is used to drill multiple holes through the thickened ovarian capsule. This procedure is called laparoscopic ovarian cauterisation or ovarian drilling or LEOS (laparoscopic electrocauterisation of ovarian stroma) . Destroying the abnormal ovarian tissue helps to restore normal ovarian function and helps to induce ovulation. For selected young patients with PCO ovaries on ultrasound ( only those with large ovaries , many follicles and increased ovarian stroma ) , if clomiphene fails to achieve a pregnancy in 4 months' time, we tell them to consider laparoscopic surgery as the next treatment option.

This is because LEOS helps us to correct the underlying problem, and about 80% of patients will have regular cycles after undergoing this surgery, of which 50% will conceive in a year's time, without having to take further medication or treatment. Having regular cycles without having to take medicines each month can be very reassuring for these patients ! The risk of this surgery is that it can induce adhesion formation, if not performed competently.Another major risk of this surgery is that if it is done for PCOS patients who do not have large ovaries, the destruction of ovarian tissue this surgery causes can end up causing infertility by reducing the ovarian reserve !

In this video, you can watch Dr Anjali Malpani perform an operative laparoscopy , in which she performs drills the ovaries to treat a patient with PCOD ( polycystic ovarian disease).

This is what the surgeon sees on the video screen when operating.

In the past, doctors used to perform ovarian surgery called wedge resection to help patients with PCOD to ovulate. The removal of the abnormal ovarian tissue in the wedge breaks the vicious cycle of PCOD, helping ovulation to occur . While wedge resection used to be a popular treatment option, the risk of inducing adhesions around the ovary as a result of this surgery has led to the operation being used as a last resort.

The good news is that with the currently available treatment options, successful treatment of the infertility is usually possible in the majority of patients with PCOD.

 

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