A laparoscopy is a surgical procedure that can be used to diagnose and treat various conditions, including endometriosis.
A laparoscope, long, thin equipment, is placed into the belly through a tiny surgical incision during a laparoscopy. This allows your doctor to view tissue or take a sample of tissue, called a biopsy. They can also remove cysts, implants, and scar tissue caused by endometriosis.
Laparoscopy for endometriosis is a minimally invasive and low-risk procedure. It is usually performed by a surgeon or gynecologist under general anesthesia. Most people leave the hospital the same day. However, sometimes night monitoring is required.
Why is endometriosis surgery performed?
Endometriosis is a condition in which the type of tissue that lines a woman's uterus grows outside of it. A surgery called laparoscopy is the only way to know for sure if you have it.
Your doctor might also recommend surgery if you have severe endometriosis pain and medicine is not helping enough. They can find endometriosis inside your body and remove all or part of the affected tissue.
There are some things to think about, even if you want to get pregnant later. You may not be able to have children after certain endometriosis operations. Talk to your doctor about the options that are right for you.
Preparation for surgery:
A surgeon will often give you specific instructions on how to prepare for surgery. These may include:
- Refraining from eating or drinking something for several hours before
- Abstaining from smoking in the days or weeks leading up to surgery
- Avoid taking certain medications on the day of surgery, if your doctor recommends it.
Doctors may also order a bowel prep or "bowel prep," which involves taking medicine to empty the bowel. Bowel prep can be an unpleasant part of preparing for surgery, but it helps the doctor safely remove endometriosis lesions from the gastrointestinal tract.
What to expect during the procedure
- A hospital gown and compression stockings will be provided to you. These tight-fitting socks will help prevent deep vein thrombosis (DVT).
- An intravenous (IV) line will be started in the person's hand by a nurse, which the anesthesiologist will use to give the anesthetic later.
- The surgeon and nurse will be present prior to surgery to answer any questions and discuss the risks and benefits of the procedure.
- Laparoscopies are performed under general anesthesia, which means the patient is entirely unconscious and ignorant of the surgery. An anesthesiologist will provide medications and monitor the person's vital signs throughout the procedure.
- The surgeon will then insert an instrument that allows him to fill the abdomen with carbon dioxide gas. The surgeon can examine the pelvic organs better by inflating the abdomen with gas.
- Then a doctor can make more incisions and insert instruments as needed to identify possible areas of endometriosis and remove samples for biopsy or as treatment.
- After the operation, surgeons will remove the instruments and close the incisions, using stitches or glue. They will then cover these incisions with bandages or other dressings.
- Innovations in surgical approaches mean that doctors can use an operational robot to perform the procedure.
- After the procedure, the nurses will take the person to the recovery room, where they will observe the person's vital signs and monitor pain levels.
- After general anesthesia, it may take some time for the person to wake up. During this period, they will be in the recovery room for a few hours.
- Typically, a person will not stay overnight after laparoscopy for endometriosis, especially if it is just a diagnostic procedure.
- However, there are some cases where a person may need to spend the night in the hospital, such as if the endometriosis was extensive and the surgeon took a long time to remove all the lesions.
- A doctor can prescribe pain relievers to take after surgery. Resting and avoiding excessive stress on the abdomen can also help.
- A person should avoid lifting, pushing, or pulling heavy objects during the first weeks of recovery to reduce the chances of a hernia.
- Recovery time varies from person to person, but if there are no complications, most people can return to their normal activities within a week.
- A person's first period after laparoscopy can be more intense and painful than usual. It is essential to take time to rest if necessary and prepare additional pain relievers and sanitary napkins in advance.
Is it effective?
Laparoscopic surgery is associated with a decrease in general pain both at 6 and 12 months after surgery. Pain caused by endometriosis can eventually come back.
The link between endometriosis and infertility remains unclear. According to the European Society for Human Reproduction and Embryology, endometriosis affects up to 50% of infertile women
In one small study, 71 percent of women under the age of 25 who had laparoscopic surgery to treat endometriosis became pregnant and gave birth. Conceiving without the use of assisted reproductive technologies is more difficult if you are over 35 years old.
For women seeking infertility treatment experiencing severe endometriosis, in vitro fertilization (IVF) may be suggested as an alternative to laparoscopic surgery.
Although laparoscopy is generally safe, although it includes some complications:
- Internal bleeding
- Hernia (a lump caused by poor healing) at the incision sites
- Damage to a blood vessel or other organs, such as the stomach, intestines, or bladder.
- Call your doctor right away or go to the emergency room if you have a fever after surgery or severe pain, swelling, or redness.
Pain and fertility results
Most women who have laparoscopic surgery feel better. But some, around 20%, will get no relief.
Some studies show that laparoscopic surgery can increase your chances of having a baby, but every case is different. Your surgeon can "rate" your endometriosis on a scale of 1 to 4:
- Stage 1 - Minimum
- Stage 2 - Mild
- Stage 3 - Moderate
- Stage 4 - Serious
If your endometriosis is stage 1, removing scars during surgery can increase your chances of getting pregnant. If it is scored stage 4, surgery could help improve the function of the ovaries and fallopian tubes, which could improve your chances of getting pregnant. But you should discuss this with your doctor.