Laparoscopy is the most common surgical procedure for diagnosing and treating endometriosis. For the most part, performing laparoscopy for endometriosis is the only way of confirming endometriosis. That’s because directly viewing the uterus is the only way to assess the severity and rate of growth of endometriosis implants.
Also known as key-whole surgery, laparoscopy is a relatively minor operation. The surgeon creates a small incision then inserts a lighted viewing apparatus called a laparoscope to assess the disease. Mild to moderate forms of endometriosis are first prescribed hormone therapy if the patient is presenting symptoms. If hormone therapy doesn’t work, that’s when the doctor would recommend laparoscopy for endometriosis.
Preparing for Laparoscopy for Endometriosis
Preparations for laparoscopy may vary from case to case, depending on the doctor’s recommendations and hospital protocol. But for most cases, patients have to make the following preparations:
- Diet and drink. It is usually recommended that patient should not eat or drink anything at least 8 hours before a surgical procedure. Make sure to ask your surgeon whether this rule applies in your case and what foods or drinks you can take, what you can’t take, and how much food or drink you’re allowed to consume.
- Allergies. Make sure to prepare a list of anything you’re allergic to, especially food or drugs. It’s better if you also include your family’s medical history and list of allergens.
- Person to call in case of emergency. Laparoscopy is a very safe procedure; however, unexpected complications have been known to happen. Make sure to provide the hospital with a list of people that they should contact in case anything happens.
- Transportation. Laparoscopy is still surgery, so it’s not recommended that you drive yourself home after the procedure. Make sure you have someone, a friend or a family member, to drive you to the hospital and back home after the procedure.
- Questions. Prepare a list of questions you want to ask your doctor before and after the procedure. It’s your body and you’re entitled to have all the information you need. You can ask your doctor what you should expect during laparoscopy and what you should to do to take care of yourself after the procedure.
What Happens During Laparoscopy
First, the patient is placed under anesthesia. The procedure starts by inserting the laparoscope into the pelvis through a small surgical incision. The balloon at the end of the laparoscope is then inflated with gas (carbon dioxide or nitrous oxide). The inflated balloon pushes the abdominal wall from the organ to give the surgeon room to operate and see the affected organ clearly. Additional incisions might be needed to move internal organs for a better view and make the operation easier. This procedure usually lasts for 30 to 45 minutes.
The end of the laparoscope also has other tools that allow the surgeon to perform various techniques like cutting and removing the affected tissue (excision) or disintegrating it with a laser or electric current (electrocautery). Using these tools, the surgeon removes the endometriosis scars or implants on the uterus. The length of the operation depends on what techniques are performed and the area of the endometriosis implants to be removed. After the surgery, incisions in the abdomen are stitched together properly to minimize scaring.
Outcomes Of Laparoscopy For Endometriosis
Laparoscopy is very effective in treating endometriosis and it has very good treatment outcomes. Compared to invasive surgery, laparoscopic surgery has less tissue trauma, minimal scarring and smaller incisions and, most importantly, faster recovery time. Like endometriosis hormone therapy, surgery relieves pain, but it’s not a 100% guarantee. 1% to 3% of women who have undergone laparoscopy will continue to experience endometriosis pain.
Recurrence is also a major concern with endometriosis. 45% of the women who had laparoscopy for endometriosis may experience a recurrence within a year after the procedure. Fortunately, studies show that hormone therapy after surgery can prevent the pain from returning and prevent recurrence of endometriosis.
One of the main concerns with regards to endometriosis is the preservation of fertility. Studies have proven that removing mild endometriosis improves fertility. Laparoscopy for moderate cases of endometriosis also improves a woman’s chances of conceiving. Severe cases of endometriosis treated with laparoscopy will require a fertility specialist, and possibly in vitro fertilization, if the woman wants to become pregnant.
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