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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.

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