Laparoscopy for Endometriosis

What is Laparoscopy for Endometriosis?

Laparoscopy is a surgical procedure that allows a doctor to visually inspect the inside of the abdomen and pelvis using a thin, lighted tube called a laparoscope. During the procedure, small incisions are made in the abdomen, and the laparoscope is inserted through one of these incisions. The doctor can see inside the abdomen and pelvis and diagnose or treat conditions such as endometriosis. This procedure is less invasive than traditional surgery, and recovery times are often shorter.

Who Should Undergo Laparoscopy for Endometriosis?

Laparoscopy for endometriosis is typically recommended for women who have symptoms of endometriosis but have not responded to non-surgical treatment options. These symptoms may include pelvic pain, heavy or irregular periods, and infertility. The procedure may be recommended for women planning to become pregnant, as endometriosis can make it more difficult to conceive.

Laparoscopy is usually done after a diagnosis of endometriosis is confirmed through other means, such as a pelvic exam, ultrasound, or MRI, and the decision to do a laparoscopy is made by a gynaecologist after a thorough assessment of the symptoms and examination of the patient.

Certain underlying medical conditions may increase the risks of laparoscopy and this needs to be weighed up against any anticipated benefits.

What are the Benefits of Laparoscopy for Endometriosis?

Laparoscopy for endometriosis can have several benefits, including

Diagnosis: Laparoscopy is the gold standard for diagnosing endometriosis. It allows the surgeon to visualise and confirm the presence of endometrial tissue outside the uterus.
Treatment: During the laparoscopy, the surgeon can remove or destroy endometrial tissue, which can reduce or eliminate symptoms of endometriosis, such as pelvic pain and heavy periods.
Fertility: Endometriosis can negatively impact fertility, and laparoscopy can help improve the chances of conception.
Minimally Invasive: Laparoscopy is considered a minimally invasive surgery, which means it is less invasive than traditional surgery. This often results in less pain, shorter recovery times, and fewer complications.
Cost-effective: Laparoscopy is usually less expensive than open surgery, and recovery time is faster, so patients can return to normal activities sooner.

While laparoscopy can effectively treat endometriosis, it is not a cure, and symptoms may return over time. A follow-up with Dr Crawford should be done after the procedure to monitor the signs and to decide if further treatment is needed.

What to Expect Before Laparoscopy for Endometriosis?

Before a laparoscopic surgery for endometriosis, you can expect the following:

Consultation: You will talk with your surgeon to discuss your medical history, symptoms, and treatment options. Your surgeon will also perform a physical examination.
Preoperative evaluation: You may need blood tests, a urine test, an ECG and other tests to ensure you are healthy enough for the surgery.
Medications: Before the surgery, you may be asked to stop taking certain medications, such as blood thinners.
Fasting: You will be instructed not to eat or drink anything for a certain period before the surgery.
Anaesthesia: You will be given general anaesthesia, which will put you to sleep during the surgery.
Duration: The surgery usually takes about one to two hours.
Recovery: After the surgery, you will be taken to the recovery room, where you will be monitored for complications. You will be given instructions on how to care for yourself at home during recovery.
Follow-up: You will have a follow-up appointment with your surgeon to discuss the surgery and recovery.

What Happens During Laparoscopy for Endometriosis?

During a laparoscopic surgery for endometriosis, the surgeon will make a few small incisions in the abdomen and insert a laparoscope (a thin, lighted tube) through one of the incisions. The laparoscope has a camera on the end, allowing the surgeon to see inside the abdomen and pelvis. Carbon dioxide gas is usually used to inflate the abdominal cavity; this allows the surgeon to see better and move more efficiently.

Once the surgeon has visualised the inside of the abdomen and pelvis, they will then use small instruments, including scissors, forceps and others, passed through the other small incision(s) to remove or destroy any endometrial tissue that is found outside the uterus. The tissue can be burned (cauterised), cut or removed with special instruments.

The surgery usually takes about one to two hours. After the surgery, the incisions will be closed with stitches, and dressings will be applied. You will be taken to the recovery room, where you will be monitored for complications.

It is important to note that the specifics of the surgery can vary depending on the size, location, and extent of the endometriosis, as well as the surgeon's expertise and preference.

What Happens After Laparoscopy for Endometriosis?

After a laparoscopic surgery for endometriosis, you can expect the following:

Recovery area: After the surgery, you will be taken to the recovery room, where you will be monitored for complications. You will be given pain medication as needed to manage any discomfort.
Discharge: Depending on the complexity of the surgery, you may be able to go home the same day, or you may need to stay overnight in the hospital.
Post-operative instructions: Your surgeon will instruct you how to care for yourself at home during recovery. This may include instructions on how to care for the incisions, how to manage pain, and when to follow up with your surgeon.
Recovery time: Recovery time can vary depending on the complexity of the surgery and the individual patient, but most patients can return to normal activities within 2 weeks, but at times may take up to 4-6 weeks..
Pain management: You may have some discomfort and pain during the recovery period, which can be managed with over-the-counter pain medication or prescription pain medication as advised by your surgical team.
Follow-up: You will have a follow-up appointment with your surgeon to discuss the surgery and recovery. Your surgeon will also advise on the need for any further treatment, such as hormone therapy or other medications.

Follow the instructions your surgeon gives before, during and after the procedure, schedule any follow-up appointments, and report any concerning symptoms or issues as soon as possible.

Laparoscopy for Endometriosis Prognosis

The prognosis for laparoscopic endometriosis surgery varies depending on the individual case. The procedure can reduce or eliminate symptoms such as pelvic pain, heavy periods, and infertility. However, it is not a cure; symptoms may return over time.

The success of the surgery depends on the extent, location, and severity of the endometriosis, as well as the expertise of the surgeon. In some cases, endometriosis recurs within a few years of surgery, and additional treatment may be needed, such as medication or repeat surgery.

Most patients benefit from the surgery and have a good outcome, with improvement in their symptoms and quality of life. Surgery may also improve the chances of conception in case of infertility.

Surgery should be considered as one of the options for the treatment of endometriosis. It is best to discuss with Dr Crawford the best treatment options for you and the possible outcomes and risks of the surgery.

Dr Crawford works with a team of Advanced Laparoscopic surgeons at Alana healthcare. If your case is considered to be particularly complex, she may recommend involving one of these doctors in your care.

Laparoscopy for Endometriosis Risks

Endometriosis laparoscopic surgery, like any surgery, has certain risks. Some of the risks associated with this procedure include the following:

Infection: As with any surgical procedure, there is a risk of infection at the incision site.
Bleeding: There is a risk of bleeding during the surgery.
Injury to surrounding organs: There is a risk of injury to surrounding organs such as the bladder, bowel or ureters during the surgery.
Adhesions: Endometriosis can cause the formation of adhesions, bands of scar tissue that can bind organs together. Surgery can cause the formation of new adhesions or exacerbate existing ones.
Anaesthesia risks: There is a risk of complications from the anaesthesia used during the surgery.
Recurrence: Endometriosis can recur after surgery, and additional treatment may be needed.
Ongoing or worsened pelvic pain: occasionally pain is not improved following laparoscopic surgery for endometriosis and may be worsened.
Nausea, vomiting, and constipation: These symptoms may occur as a side effect of the anaesthesia or pain medication used during the surgery.

Cost of Laparoscopy for Endometriosis

The price will also depend on whether the surgery is done in a public or private hospital.

If you are planning for surgery in the private sector, you will be provided with a surgical quote estimate prior to the surgery. If you have private health insurance you should check with your health insurance to understand what is covered and what out-of-pocket costs you may incur.