Laparoscopy for Endometriosis


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The endometrium is the tissue that lines the inside of the womb (uterus). Endometriosis is a condition where endometrial tissue is found outside the uterus.

Who gets endometriosis?
The exact number of women who develop endometriosis is not known. This is because many women have endometriosis without symptoms, or with mild symptoms, and are never diagnosed.
Investigations to diagnose endometriosis are only done if symptoms become troublesome and are not eased by initial treatments. If symptoms develop they typically begin between the ages of 25-40. Sometimes symptoms begin in the teenage years. Endometriosis can affect any woman. However:
Sometimes it runs in families. Therefore, endometriosis is more common in close blood relatives of affected women.
Endometriosis is rare in women past the menopause, as to develop endometriosis you need estrogen, the female hormone. Estrogen levels fall after the menopause.
The combined oral contraceptive pill (often called ‘the pill’) reduces the risk of developing endometriosis. This protective effect may persist for up to a year after stopping ‘the pill’.
What causes endometriosis?
What are the symptoms of endometriosis?
How is the endometriosis diagnosed?
The symptoms caused by endometriosis can be caused by other conditions. Therefore, if any of the above symptoms become persistent then tests are usually advised to find the cause of the symptoms. Endometriosis is usually confirmed by a laparoscopy. This is a small operation that involves making a small cut, in the abdominal wall below the umbilicus. A thin telescope-like instrument (a laparoscope) is pushed through the skin to look inside. Patches of endometriosis can be seen by the doctor.
How can the endometriosis be treated?
Endometriosis can be treated at the time of diagnosis. Endometriosis patches can be cut away (excised) or burned away. Treatment with laparoscopy is more difficult with advanced disease that involves large areas of the rectum or larger lesions.
Advanced laparoscopic surgery for chronic pelvic pains and suspected endometriosis should be performed by a surgeon with the necessary skills and expertise in the resection of such lesions and in an operating room equipped for such a surgery. Care should be taken to perform endometriotic patches as complete as possible. Adhesions (scar tissues) should be completely resected and measures preventing their reformation should be applied. The surgeon should also be prepared to resect endometriotic lesions that may involve other organs.