Can Endometriosis Be Treated with Laparoscopy?

Can Endometriosis Be Treated with Laparoscopy?

Endometriosis is a medical condition characterized by the growth of tissue similar to the lining of the uterus outside the uterus. It often affects the ovaries, fallopian tubes, and the lining of the pelvis. In rare cases, this tissue may appear outside the pelvic area.

Typically, this condition is painful, especially during menstruation, and can cause heavy periods or bleeding between periods, prompting women to seek treatment. Treatments range from medication to surgery, and laparoscopy is now an approved method for treating this condition due to its benefits, which will be discussed in this article.

Laparoscopic Treatment for Endometriosis

Laparoscopic treatment for endometriosis involves making several small incisions in the abdomen to insert the laparoscope and surgical instruments. This approach is known for its precision, effectiveness, and minimal side effects, making it a safe option. Studies have shown that up to 70% of women will have no evidence of endometriosis recurrence five years after the surgery.

Can Laparoscopic Treatment Be Used for All Cases of Endometriosis?

Not all cases of endometriosis can be treated with laparoscopy. In some instances, endometriosis may affect other organs such as the intestines, ureter, or bladder, which may require more extensive surgery later.

When is Laparoscopic Treatment for Endometriosis Recommended?

Laparoscopic treatment may be recommended in the following situations:

• Persistent severe abdominal pain thought to be caused by endometriosis.
• Symptoms continue or recur despite hormonal treatment.
• Endometriosis affects other organs, such as the bladder or intestines.
• Endometriosis causing infertility.
• Growth of an endometrioma on the ovary.

Pre-Operative Preparations

Patients are given instructions to follow before the procedure to avoid complications, including:

• Fasting for at least 8 hours before the procedure.
• Possibly stopping certain medications or supplements temporarily before the procedure.
• Quitting smoking.

Steps in Laparoscopic Treatment for Endometriosis

Typically performed under general anesthesia, the procedure lasts between 30 minutes to 3 hours or more, depending on the location and severity of the tissue.

The procedure includes:

• Making a small incision in the abdomen, usually below the navel.
• Inserting a small tube called a cannula through the incision to inflate the abdomen with gas, usually carbon dioxide, to improve visibility.
• Inserting the laparoscope through the incision, which is a long, thin tube with a small camera at the end that allows the surgeon to view the internal organs on a screen.
• Identifying and treating endometrial lesions or scar tissue using techniques such as:
  • Surgical removal of the tissue.
  • Destruction of scar tissue using freezing, heat, electricity, or laser.
• Closing the incision with stitches once the procedure is complete.

Post-Operative Care

After the procedure, women may experience temporary side effects, including:

• Side effects from anesthesia, such as dizziness, nausea, and vomiting.
• Discomfort from excess gas.
• Light vaginal bleeding.
• Mild pain at the incision site.
• Abdominal pain.

Recommendations During Recovery

Post-hospital and recovery recommendations include:

• Avoiding certain activities immediately after surgery for at least a week or as advised by the doctor, such as:
• Strenuous exercise.
• Bending forward.
• Lifting heavy objects.
• Sexual activity.
• Getting adequate rest.
• Eating a nutritious diet and drinking plenty of fluids.
• Performing light activities (e.g., walking) to help expel excess gas.
• Keeping the incision clean and dry.
• Allowing time for the body to heal.

The doctor may schedule follow-up appointments between 2 to 6 weeks after the surgery.

How Effective is Laparoscopic Treatment for Endometriosis?

Some studies have shown a reduction in pain associated with endometriosis 6 to 12 months after surgery. However, endometriosis may recur, potentially requiring additional procedures.

Research indicates that 71% of women under 25 who underwent laparoscopic surgery for endometriosis were able to conceive and deliver naturally.

 Complications of Laparoscopic Surgery

Although rare, laparoscopic surgery carries some risks, including:

• Infections in the bladder, uterus, or surrounding tissues.
• Uncontrolled bleeding.
• Injury to the intestines, bladder, or ureter.
• Scarring.

Immediate consultation with a doctor is necessary if any of the following symptoms occur:

• Severe pain.
• Persistent nausea or vomiting lasting more than a day or two.
• Increased bleeding.
• Increased pain at the incision site.
• Unusual vaginal discharge.
• Abnormal discharge from the incision site.
• Pain not relieved by pain medication.
• Fever.

Read More: Blocked Fallopian Tubes

References:

1. The Royal Women’s Hospital. (n.d.). Laparoscopy and endometriosis. https://www.thewomens.org.au/health-information/periods/endometriosis/laparoscopy-and-endometriosis