Laparoscopic Surgery for Endometriosis (Methods of diagnosis and treatment)

Endometriosis — a disorder in which tissue that normally lines the inside of your uterus (the endometrium) grows outside your uterus — is often a challenging condition to diagnose. Its symptoms can be unclear and similar to symptoms of other conditions. Because of this, many women experience endometriosis symptoms for up to 10 years or more before they receive a diagnosis and appropriate treatment. An early diagnosis of endometriosis could help you better manage your symptoms. Laparoscopy is the most common procedure used to diagnose and remove mild to moderate endometriosis. Instead of using a large abdominal incision, the surgeon inserts a lighted viewing instrument called a laparoscope through a small incision. If the surgeon needs better access, he or she makes one or two more small incisions for inserting other surgical instruments.

7 signs you might have endometriosis

Endometriosis signs and symptoms include:

  • Painful periods (dysmenorrhea)
  • Pain in your pelvic area, belly or lower back
  • Pain during or after sex (dyspareunia)
  • Excessive bleeding
  • Difficulty getting pregnant (infertility)
  • Pain with bowel movements or urination
  • Fatigue and digestive symptoms

If your doctor recommends a laparoscopy, it will be to:

  • View the internal organs to look for signs of endometriosis and other possible problems. This is the only way that endometriosis can be diagnosed with certainty. But a “no endometriosis” diagnosis is never certain. Growths (implants) can be tiny or hidden from the surgeon’s view.
  • Remove any visible endometriosis implants and scar tissue that may be causing pain or infertility. If an endometriosis cyst is found growing on an ovary (endometrioma), it is likely to be removed.

You’ll be given a general or a local anesthetic prior to the surgery to induce either general or local anesthesia. Under general anesthesia, you’ll fall asleep and not feel any pain. It’s usually administered through an intravenous (IV) line, but may also be given orally. Under local anesthesia, the area where the incision is made will be numb. You’ll be awake during the surgery, but won’t feel any pain.

During the laparoscopy, your surgeon will make an incision in your abdomen, typically under your bellybutton. Next, a small tube called a cannula is inserted into the opening. The cannula is used to inflate the abdomen with gas, usually carbon dioxide or nitrous oxide. This helps your surgeon to see the inside of your abdomen more clearly. Your surgeon inserts the laparoscope next. There’s a small camera on the top of the laparoscope that allows them to see your internal organs on a screen. Your surgeon may make additional incisions to get a better view. This can take up to 45 minutes. When endometriosis or scar tissue is found, your surgeon will use one of several surgical techniques to treat it. These include:

  • Excision. Your surgeon will remove the tissue.
  • Endometrial ablation. This procedure uses freezing, heating, electricity, or laser beams to destroy the tissue.

Once the procedure is finished, your surgeon will close the incision with several stitches.