**2.1. Rationale of expectant therapy**

Any treatment should be compared to expectant therapy.

© 2012 Darwish, licensee InTech. This is an open access chapter distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. © 2012 Darwish, licensee InTech. This is a paper distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Endoscopy versus IVF: The Way to Go 29

**2.4. Advantages of laparoscopy over ART**

Physically and psychologically sound patient.

less post-operative pain and discomfort, and

body reaction, and leaving raw surfaces.

earlier resumption of normal activities and employment.

reduced contamination of the surgical field with glove powder or lint.

**2.6. Fertility-preserving reconstructive gynecologic surgery** 

cosmetically most acceptable.

 shorter hospital stay. lower incidence of ileus.

faster recovery.

genital organ.

tissue planes **.** 

surgery, it's the surgeon!

(5).

Tubal reconstructive surgery remains an important option for many couples and surgery should be the first line approach for a correct diagnosis and treatment of tubal infertility (4).

**2.5. Advantages of endoscopic management over conventional management** 

 bleeding is reduced due to tamponade of small vessels by the pneumoperitoneum drying of tissues is minimal because surgery occurs in a closed environment

easy intraoperative access to the pouch of Douglas and the posterior aspects of the

**Avoidance of serosal insults:** tissue trauma, ischemia, hemorrhage, infection, foreign-

 **minimizing tissue trauma:** by using atruamatic techniques, meticulous hemostasis, complete excision of abnormal tissues and precise alignment and approximation of

**Evidence of superiority of Laparoscopic reconstructive surgery:** one study proved that reconstructive surgery achieves a double pregnancy rate than non-reconstructive surgery

Among experienced endoscopists, it's well known that it's not the robot that does the

In a retrospective study, both robotically-assisted laparoscopic and standard laparoscopic treatments of endometriosis had excellent outcomes. The robotic technique required

**2.7. Is there a role for robotic surgery in improving pregnancy rate?**

significantly longer surgical and anesthesia time, as well as larger trocars (6).

 Excellent results. Long-lasting efficacy. Reconstructive concept.

**Table 1.** Lines of infertility management
