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The fertiloscope is a type of laparoscope, modified to make it suitable for trans-vaginal application, which is used in the diagnosis and treatment of female infertility. This relatively new surgical technique is used for the early diagnosis and immediate treatment of a number of disorders of the female reproductive organs and can be considered one of the first standard NOTES (Natural Orifice Transluminal Endoscopic Surgery) procedures. A large body of published research is available on the application of this surgical technique using the device. Fertiloscopy provides a minimally invasive, potentially office-based procedure for the clear diagnosis of two major causes of infertility in a manner enabling rational choices at the start of infertility treatment. Published evidence indicates improvement in pregnancy rates with reductions in costs.〔Watrelot A, Dreyfus J M. "Fertiloscopy: Review of a 1500 Continuous Case Series." ''JSLS, Journal of the Society of Laparo-endoscopic Surgeons''. Volume 10, Number 3〕 == Literature review == The published evidence into the use of Fertiloscopy falls into two categories; those studies linked with the original research into the technique itself, and the later (post 2002) evaluations of the product after it was fully developed. #The original technique was a development of a surgical procedure called culdoscopy which was widely used in the 1960s and 1970s. This was a transvaginal technique performed via the vagina with a conventional laparoscope. This fell out of general use, in most countries most probably because culdoscopy could not offer any advantages over laparoscopy #Campo, Broesens, Gordts and Watrelot were among the first to propose and report on the development of a standardised procedure of "transvaginal hydrolaparoscopy" and a special instrument for it - initially a modified reusable laparoscope.〔Watrelot A., Gordts S., Andine J.P., Brosens I. Une nouvelle approche diagnostique : La Fertiloscopie Endomag, 1997,21,7-8〕〔Gordts S, Campo R, Rombauts L, & Brosens I. Transvaginal hydrolaparoscopy as an outpatient procedure for infertility investigation. Human Reproduction 13(), 99-103. 1998.〕〔Brosens I, Campo R, & Gordts S. Office hydrolaparoscopy for the diagnosis of endometriosis and tubal infertility. Current Opinion in Obstetrics and Gynecology 11, 371-377. 1999.〕〔Campo R, Gordts S, Rombauts L, & Brosens I. Dignostic accuracy of transvaginal hydrolaparoscopy in infertility. Fertility and Sterility 71, 1157–1160. 1999.〕〔A.Watrelot, J.M.Dreyfus and J.P.Andine Centre de Recherche et d'Etude de la Sterilite´, 85 cours Albert Thomas-69003, Lyon, France. Evaluation of the performance of fertiloscopy in 160 consecutive infertile patients with no obvious pathology . Human Reproduction vol.14 no.3 pp.707–711, 1999〕 From that point on, there have been many studies into the transvaginal technique. #An integral member of the initial teams working on the technique, Watrelot decided to develop a disposable instrument with extended capabilities that make a more comprehensive procedure possible. He included in the device a conventional hysteroscope so that the total procedure includes not only the transvaginal laparoscopy, but also hysteroscopy, and the so-called "laparoscopy and dye" test for tubal patency. This device became known as the Fertiloscope and from it is derived the name for the current technique that uses it; Fertiloscopy. There is a recent review of alternative methods of assessing tubal patency by Papaioannou, Afnan and Jafettas in 2007 that makes clear that "lap and dye" is the gold standard procedure for assessing tubal patency.〔S. Papaioannou, M. Afnan, J. Jafettas. Heart of England NHS Foundation Trust, Birmingham, UK; Birmingham Women's Health Care NHS Trust, Birmingham, UK; 32nd Department of Obstetrics and Gynecology, Aristoteleion University of Thessaloniki, Hippokration General Hospital, Thessaloniki, Greece. Symposium: Tubal disease and fertility outcome. Tubal assessment tests: still have not found what we are looking for. Vol 15. No 4. 2007 376-382 Reproductive BioMedicine Online〕 #Watrelot also recommends the use of a special type of scope with a 30-degree chamfered end which makes it possible to examine the inside of the fallopian tubes and visualise the depths of the folds under 100 fold magnification, so that mucosal damage can be assessed. Watrelot and Dreyfus (2000),〔Watrelot A & Dreyfus J. Explorations intra-tubaires au cours de la fertiloscopie. Reproduction Humaine et Hormones 13(), 39-44. 2000.〕 Watrelot and Grudzinskas (2003) 〔Watrelot A, Hamilton J, & Grudzinkas J. Advances in the assessment of the uterus and fallopian tube function. Best Practice & Research in Clinical Obstetrics & Gynaecology 17(), 187-209. 2003.〕 Watrelot, Dreyfus and Cohen (2002),〔Watrelot A, Dreyfus J, & Cohen M. Systematic salpingoscopy and microsalpingoscopy during fertiloscopy. A 500 cases report. J Am Ass Gynae Lap 9, 117-123. 2002.〕 Swart, van Beurden, Mol, Redekop, van der Veen and Vossuyt (1995)〔Swart P, van Beurden M, Mol B, Redekop W, van der Veen F, & Bossuyt P. The accuracy of hysterosalpingography in the diagnosis of tubal pathology: a meta-analysis. Fertility and Sterility 64(), 486-491. 1995.〕 and Yablonski Sarge and Wild (1990)〔Yablonski M, Sarge T, & Wild R. Subtle variations in tubal anatomy in infertile women. Fertility and Sterility 54, 455-458. 1990.〕 have published on the value of visualisation of the tubal mucosa under magnification (microsalpingoscopy). #Watrelot, Nisolle, Chelli, Hocke, Rongieres and Racinet (2003)〔Watrelot A, Nisolle M, Chelli H, Hocke C, Rongieres C, Racinet C; International Group for Fertiloscopy Evaluation. Centre de Recherche et d'Etude de la Sterilite, 69003-Lyon, France. watrelot@wanadoo.fr. Human Reproduction, Vol. 18, No. 4, 834-839, April 2003. Is laparoscopy still the gold standard in infertility assessment? A comparison of fertiloscopy versus laparoscopy in infertility. Results of an international multicentre prospective trial: the 'FLY' (Fertiloscopy-LaparoscopY) study.〕 is a comparison of the results obtained by the "gold standard" methodology of lap and dye and Fertiloscopy in a series of patients who underwent both procedures (by two surgeons, blind to each other's results). This study showed that there is a high degree of concordance between laparoscopy and fertiloscopy in the identification of adhesions and endometriosis. #Further papers such as those by Watrelot and Dreyfus have reported in the Journal of the Society of Laparoendoscopic Surgeons 2007 a retrospective analysis of over 1500 patients. Watrelot received a medal from the society for this publication, in October 2006.〔Watrelot A, Dreyfus J M. Fertiloscopy: Review of a 1500 Continuous Case Series. JSLS, Journal of the Society of Laparoendoscopic Surgeons. Volume 10, Number 3 2007〕 #The use of the technique has broadened over the past few years with further publications examining effectiveness in standard clinical practice for example Nohuz, Pouly, Bolandard, Rabishong, Jardon, Cotte, Rivoire and Mage (2006),〔Nohuz E, Pouly J-L, Bolandard F, Rabischong B, Jardon K, Cotte B, Rivoire C, & Mage G. Fertiloscopie: l'exprience clermontais. Gynécologie Obstétrique Fértilité 34, 894-899. 2006.〕 as well as those reporting on new applications such as ovarian drilling for Polycystic Ovarian Syndrome (PCOS)〔Fernandez H, Watrelot A, Alby JD, Kadoch J, Gervaise A, deTayrac R, Frydman R. Fertility after ovarian drilling by transvaginal fertiloscopy for treatment of polycystic ovary syndrome. J Am Assoc Gynecol Laparosc. 2004 Aug;11(3):374-8. Service de Gynécologie-Obstétrique, Hôpital Antoine Beclere, Assistance Publique-Hôpitaux de Paris, Clamart, France.〕 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Fertiloscope」の詳細全文を読む スポンサード リンク
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