Laparoscopy for Endometriosis - An Overview of Procedure
Laparoscopy is the type of endometriosis surgery most
commonly used to make an accurate diagnosis of the disease
and to remove misplaced endometrial tissue. The surgeon
needs to make only a small incision to fit the laparoscope,
which is an instrument similar to a thin telescope with
a light. This procedure is preferable to making a large
abdominal incision which prolongs recovery and carries
with it a greater risk.
The reason for the surgery is two-fold. Firstly, your
doctor might suggest the procedure to make a firm diagnosis
of endometriosis before proceeding with treatment. Laparoscopic
surgery is the only way that an accurate diagnosis can
be made, although, even if the surgeon could not find
any evidence of endometriosis, this doesn't mean you
don't have the disease because small amounts of the
tissue could be hidden from view. The second reason for laparoscopy for endometriosis
is to remove visible misplaced endometrial tissue, called
implants, and any scar tissue that could be the cause
of pain, discomfort or infertility. Sometimes endometriosis
cysts, or endometrioma, are found on the ovaries and
these can also be removed.
Laparoscopic surgery is generally performed under a
general anesthetic, by a gynecologist; it is also possible
to have a local or spinal block anesthetic for the surgery,
in which case you will be awake. It is not a long procedure,
normally taking between 30 and 45 minutes with the actual
time dependant on exactly what the surgeon needs to
do.
During the laparoscopy procedure the abdominal cavity
is injected with a gas to allow the abdominal wall to
pull away from the organs to allow for better viewing.
After making a small incision in the abdomen, the surgeon
inserts the laparoscope to view and carefully examine
the abdominal organs for signs of endometriosis. If
there are endometriosis implants present, they may be
removed at this time by excision, or destroyed by electrocautery
or laser beam.
The next stage in the procedure is to close the incision
which the surgeon does with a few small stitches so
that there is often not even a scar. You will be taken
to a recovery room to wake up and be under observation
for a short time.
Endometriosis laparoscopy is commonly performed at
a day surgery or outpatient clinic as patients are rarely
required to stay overnight in hospital. You might need
to stay for the whole day of your surgery but will probably
then be able to go home. Before the laparoscopy procedure,
you might be instructed to have nothing to eat or drink
for the eight hours leading up to the surgery time;
this is to help prevent any complications with the anesthetic.
You would be advised to get someone to drive you home
afterwards as you might not feel 100%.
After the laparoscopic surgery, you should take it
easy and rest for a week or so to allow your body to
fully recover. After a week, you will probably be able
to return to your usual activities and lifestyle, unless
instructed otherwise by your gynecologist. It is wise
to remember that you have had surgery, even if it wasn't
a major procedure; don't try to do too much, or anything
too strenuous, for a couple of weeks.
Your gynecologist will possibly want to see you again
after your laparoscopy for endometriosis, to check everything
is alright and to assess the results of the surgery
as far as your endometriosis symptoms are concerned. |