What is Laparoscopic Surgery for Endometriosis?

If you have endometriosis, you probably have painful and heavy periods, awful cramps, and might not even enjoy sex anymore because it’s so uncomfortable.

Experts don’t know what causes endometriosis, but it involves the lining of your uterus, which is called the endometrium. With the condition, pieces of the endometrium that are shed during menstruation become attached to organs like your ovaries and fallopian tubes.

It’s not just painful, but it can also make it difficult for you to have a children.

And while there is no known cure, there are treatments to help shrink tissue growth and ease your pain.

Treatment Options

Treatment for your endometriosis usually will include medication or surgery, depending on its severity. Your doctor may first have you try hormone therapy like birth control pills, progestin therapy (IUDs), danazol, and pain medications like elagolix (Orilissa). But if these don’t improve your symptoms, they may suggest laparoscopic surgery to remove the endometriosis.

Why Laparoscopic Surgery?

Even though you have symptoms of endometriosis, the only way for your doctor to 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.

Your surgeon can remove any endometriosis scarring and lesions during the laparoscopy, as well. Depending on how much endometriosis the surgeon has to remove, the procedure can last anywhere from 30 minutes to 6 hours or more.

After Surgery

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 experience some pain when you wake up. Make sure to discuss your symptoms with your doctor so they can manage your care and help make you comfortable.

You’ll probably be tired for the first few days after surgery, as well. You may not be able to drive, have sex, swim, or bathe (showering is OK) until your doctor tells you otherwise.

Risks

Laparoscopy is relatively safe, but 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

Call your doctor immediately or go to an emergency room if you get a fever after surgery, or if you have severe pain, swelling, or redness.

Outcomes for Pain and Fertility

Most women who have laparoscopic surgery do feel better. But some, about 20%, won’t get any relief.

Some studies show that laparoscopic surgery can increase 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 1 -- minimal
• Stage 2 -- mild
• Stage 3 -- moderate
• Stage 4 -- severe

If your endometriosis is stage 1, removing scarring during surgery can increase your chances of getting pregnant. If it’s scored stage 4, the surgery could help improve the function of your ovaries and fallopian tubes, which might improve your chances of getting pregnant. But you should discuss this with your doctor.

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