Laparoscopic Surgery for Endometriosis

Endometriosis is a disease in which tissue that normally lines the inside of the uterus- the endometrium, grows outside the uterus. Endometriosis most commonly involves the ovaries, bowel or the tissue lining the pelvis and may cause adhesions-binding of tissues. When endometriosis involves the ovaries, cysts called endometriomas may form. 

Endometriosis can cause pain sometimes severe, especially during periods. Fertility problems also may develop. There may be pain during defecation or severe pain during sexual intercourse. Surgery may be required if symptoms persist despite medication or if patient is not able to conceive despite treatment

Laparoscopy is used to both diagnose and treat endometriosis. Endometrial lesions can be cut away (excised) or burned away(ablated). Laproscopic ovarian cystectomy can be done for endometriomas and adhesions can be removed.

This surgery is done using a laparoscope, which is a slender, fiber-optic tube equipped with a miniature camera, lights and surgical instruments inserted through few small cuts ranging from 5mm to 1 cm in length in the abdominal wall. After a small incision is made in or above the belly button, carbon dioxide gas is introduced to distend the abdomen. Laparoscope is put in and additional smaller cuts are made under vision to introduce surgical instruments. Special instruments may be used as per need to perform the surgery successfully.

Advantages of Laparoscopic surgery for endometriosis over open surgery.

• Better visualisation with magnification leads to better surgical results.
• Lesser Blood Loss
• Less postoperative adhesion formation
• Lower Post Operative pain
• Shorter Stay at Hospital.
• Lesser abdominal wall infections 
• Fast Recovery from surgery wounds.
• Less chances of incisional hernia
• Better cosmetically as small scars

This is an advanced surgery that requires a surgeon with expertise in laparoscopic surgery. Often there are severe adhesions involving the intestines and ureter and these need to be separated carefully. In some case we may even need to cut and reanastomose the intestines or the ureter.

Please note that Laparoscopic surgery does not mean it is a minor surgery.