Endometriosis happens when tissue similar to the tissue in the lining of the uterus grows in places other than the lining of the uterus. This tissue can attach to organs like your ovaries and fallopian tubes.
Experts don't know what causes endometriosis, but it's painful and causes cramps and heavy periods. It can also make sex uncomfortable and make it difficult for you to have children.
Endometriosis Treatment Options
Depending on how serious your condition is, treatment for endometriosis usually includes medication or surgery. Your doctor may first prescribe hormone therapy such as birth control pills, progestin therapy (IUDs), and medications such as elagolix (Orilissa) to help ease your pain. But if these treatments don’t improve your symptoms, they may suggest laparoscopic surgery to remove the endometriosis.
Who May Need an Endometriosis Laparoscopic Surgery?
You may benefit from endometriosis surgery if:
- You have long-term or serious pelvic pain.
- Your doctor suggests taking out areas of endometriosis.
- Medicine doesn't ease your symptoms.
- You have trouble getting pregnant.
- Endometriosis is impacting organs such as your bowel or bladder.
Endometriosis Laparoscopy Procedure
Even if you have symptoms of endometriosis, the only way your doctor can diagnose it is by performing a laparoscopy. You’ll get general anesthesia, meaning you won’t be awake.
During the procedure, your surgeon will make a small incision near your belly button and fill your abdomen with gas to get a better look at your internal organs. Next, they’ll insert a laparoscope, which is a thin tube with a video camera, to look for scarring on your uterus, ovaries, fallopian tubes, bladder, and other organs.
Using special instruments attached to the laparoscope, your surgeon can remove any endometriosis scarring and lesions during the laparoscopy. Depending on how much endometriosis the surgeon has to remove, the procedure can last anywhere from 30 minutes to six hours or more. The last step is to close the incision with stitches.
Laparoscopic Excision vs. Ablation of Endometriosis
Your surgeon can use different methods to remove endometriosis scarring and lesions, such as cutting them, called excision, or burning or destroying them, known as ablation.
Both techniques improve pain and your chances of getting pregnant if you have superficial lesions. Doctors often use excision for deeper endometriosis or if it affects your ovaries. This type of surgery is better for preserving ovarian tissue and fertility.
Endometriosis Laparoscopic Surgery Recovery
Most people can go home soon after laparoscopic surgery, but if your procedure is more complicated, you may need to spend a night in the hospital. And you’ll need someone to drive you home.
You may have some pain when you wake up. Talk to your doctor about your symptoms so they can manage your care and help make you comfortable.
You’ll probably also be tired for the first few days after surgery. You may not be able to drive, have sex, swim, or bathe (showering is OK) until your doctor tells you otherwise.
Endometriosis Laparoscopy Risks
Laparoscopy is relatively safe, but as with all surgical procedures, there are risks involved, including:
- Internal bleeding
- Hernia (a bulge caused by poor healing) at the incision sites
- Infection
- Damage to a blood vessel or other organs, such as the stomach, bowels, or bladder
- Fistula (an abnormal connection between two organs)
Call your doctor right away or go to an emergency room if you get a fever after surgery or have severe pain, swelling, or redness.
Endometriosis Laparoscopic Surgery Outcomes
Most women who have laparoscopic surgery feel better, but some, about 20%, won’t get any relief. Research finds you'll have less:
- Period pain
- Pain in your pelvic area and back
- Pain during sex
Laparoscopic surgery can also help ease the pain of ovarian endometriomas, fluid-filled cysts that are a sign of endometriosis.
Some studies also show that laparoscopic surgery can raise your chances of having a baby, but each case is different. Your surgeon may “score” your endometriosis on a scale of 1 to 4:
- Stage I -- minimal
- Stage II -- mild
- Stage III -- moderate
- Stage IV -- severe
If your endometriosis is stage I, removing scarring during surgery can increase your chances of getting pregnant. If it’s scored stage IV, the surgery could help improve how well your ovaries and fallopian tubes work, improving your chances of getting pregnant. But you should discuss this with your doctor.
Life After Endometriosis Surgery
It could take six weeks or longer to recover from endometriosis surgery if you have an advanced case of the condition. But those with mild cases should get better faster. In most cases, you can go back to work or school within a couple of weeks after surgery. Talk to your doctor about how long your recovery could take.
Takeaways
Endometriosis happens when tissue similar to the uterine lining grows outside the uterus, often attaching to organs such as the ovaries and fallopian tubes. It can cause pain, heavy periods, and fertility challenges. While there's no cure, treatments such as hormone therapy (birth control or IUDs) and, in severe cases, laparoscopic surgery can help. Recovery typically takes a few weeks, but severe cases may require longer. Surgery can reduce pain, improve fertility, and address other health problems such as ovarian cysts.
Endometriosis Laparoscopic Surgery FAQs
Can stage IV endometriosis be removed?
Yes, doctors use surgery to treat stage IV endometriosis.
What is laparoscopic fulguration of endometriosis?
This is a type of surgery that uses a cautery device or laser to burn endometriosis lesions during laparoscopic surgery.
