Endometriosis surgery

What is endometriosis surgery?

Endometriosis surgery is a medical procedure performed to remove endometrial tissue that has grown outside of the uterus. The surgery aims to alleviate symptoms such as pain, heavy periods, and infertility caused by endometriosis.

Endometriosis surgery can offer relief from painful symptoms associated with this chronic condition but should only be considered after careful evaluation of all treatment options with your doctor including conservative therapies like hormonal therapy or lifestyle modifications like dietary changes and physical activity improvements.

What are the different types of endometriosis surgery?

Endometriosis surgery involves the removal of endometrial tissue, which is similar to the lining of the uterus but grows outside it. The type of surgery used depends on various factors such as location and severity of the endometriosis lesions.

  • Laparoscopy - this minimally invasive and involves making small incisions in the abdomen.
  • Laparotomy – this is a major surgery that requires a larger incision in the abdomen. This option may be necessary if there are large or deep-seated endometriomas.
  • Hysterectomy - this involves removing all or part of the uterus, depending on whether fertility preservation is desired. This method can be effective for women who have severe symptoms or whose endometriosis has not responded well to other treatments.
  • Excision surgery - this removes individual nodules by cutting around them with precision instruments while preserving surrounding healthy tissue. Other types include ablation procedures that use heat or laser energy to destroy superficial lesions and nerve-blocking therapy that aims to reduce pain associated with endometriosis.

It's important for patients to discuss their treatment options with their doctor and decide together what approach will work best for them based on medical history and personal goals.

Is endometriosis surgery a major surgery?

Endometriosis surgery can vary in intensity and complexity depending on the severity of the patient's condition. It is a surgical procedure to remove tissue outside of the uterus that has grown abnormally due to endometriosis. The extent of this surgery varies from person to person.

  • In some cases, endometriosis surgery may only require laparoscopy, which is considered a minimally invasive procedure. This involves making small incisions in the abdomen through which instruments are inserted, allowing surgeons to view and remove any abnormal growths.
  • However, for more severe cases involving larger growths or deep infiltration into surrounding tissues and organs, more extensive surgeries such as laparotomy or hysterectomy may be necessary. These surgeries involve larger incisions and longer recovery times.
  • While all surgeries carry some degree of risk, endometriosis surgery is generally considered safe when performed by an experienced surgeon in a proper medical facility with appropriate equipment.

Whether endometriosis surgery is considered major or not depends on individual circumstances such as the extent of tissue involvement and type of surgical approach required. It is important for patients to discuss their options with their doctor before making any decisions about treatment.

Who needs endometriosis surgery?

It's important to note that surgical intervention should be considered as a last resort after other treatments have been explored. While some cases may only require minor laparoscopic procedures to remove small patches of tissue, others may need more invasive surgery such as hysterectomy.  However, your healthcare provider may recommend it in case you are experiencing of the following:

  • persistent pelvic pain
  • difficulties in conceiving
  • Your endometriosis symptoms are not getting better with medication anymore
  • Your healthcare provider recommends removing sections of endometriosis

Alert: Endometriosis surgery remains one of the most effective ways of managing the condition's debilitating effects when all other treatments fail. However, Endometriosis can significantly impact a woman's quality of life; however, there are various treatment options available. Hence only resort to it after weighing all your options and taking the opinions of multiple doctors

Risks and Benefits

What are the risks or complications of endometriosis surgery?

As with any surgical procedure, there are risks and potential complications associated with endometriosis surgery. These can vary depending on the type of surgery you undergo, your individual health history, and other factors.

  • Some possible risks include
    • Bleeding
    • Infection
    • damage to surrounding organs or tissues during the procedure itself.
  • In rare cases, some women may experience complications such as blood clots or problems with anesthesia. It's important to discuss these risks with your doctor before deciding to undergo treatment so that you have a clear understanding of what to expect.
  • Additionally, it's worth noting that recovery from endometriosis surgery can be intense and involve a significant amount of pain and discomfort. You may need several weeks off work or regular activities while you heal.

What is the success rate of endometriosis surgery?

Even though there are risks associated with surgery for endometriosis it has a success rate of 60%, which is why many women find that undergoing treatment is ultimately worth it for the relief it provides from this chronic condition.

Procedure

What should I expect before endometriosis surgery?

Before undergoing endometriosis surgery, it's important to know what to expect.

  • Firstly, your doctor will provide you with pre-operative instructions that may include fasting for a certain period of time or stopping certain medications.
  • You'll also need to undergo some pre-surgery tests such as blood tests and imaging studies. Your doctor may also require you to undergo pelvic exams and other diagnostic procedures before the operation.
  • It’s normal to feel anxious about the procedure, so make sure to ask your doctor any questions that come up in your mind during this process. You can talk about what kind of anesthesia will be used and how long the surgery is expected to take
  • Your surgeon will likely provide you with detailed instructions on what steps you should take before arriving at the hospital on the day of surgery.
  • Preparing for endometriosis surgery requires careful planning and communication with your healthcare team. By staying informed about each step of the process, you can help ensure a successful outcome from start-to-finish.

What happens during endometriosis surgery?

  • During endometriosis surgery, the patient will be given anesthesia to ensure they are comfortable and pain-free throughout the procedure. The surgeon will then make small incisions in the abdomen or use a laparoscope to view and remove any endometrial tissue growths.
  • The extent of the surgery depends on factors such as how severe the endometriosis is, its location, and whether it has spread to other organs. In some cases, only minor tissue removal is required. However, more extensive surgeries may involve removing entire organs like ovaries or parts of the uterus.
  • After identifying all areas affected by endometriosis, surgeons can carefully excise them while avoiding harm to nearby organs. This precision ensures that patients experience fewer complications following their operation.
  • Once all of the necessary tissues have been removed or repaired successfully, physicians close up any incisions using surgical sutures or staples before sending patients off for recovery. Patients should expect to feel some discomfort for a few days after surgery but overall should recover within four weeks with proper care and rest.

Recovery

What happens after endometriosis surgery?

  • After the surgery, patients can expect to feel some pain and discomfort. Pain medication will be prescribed to help manage this discomfort. The length of hospital stay varies depending on the extent of the surgery and individual recovery time.
  • It is recommended that patients take it easy for a few weeks after surgery, avoiding heavy lifting or strenuous activity. Patients should also avoid sexual intercourse until they are advised by their doctor that it is safe to do so.
  • Postoperative bleeding may occur for a few days after surgery, but this should not be excessive. Any signs of heavy bleeding or fever should be reported immediately to your surgeon.
  • Patients will have a follow-up appointment with their surgeon about two weeks after the procedure where any stitches or staples will likely be removed if necessary. In addition, doctors often recommend continued professional support during outpatient care in order to monitor progress and ensure that no complications arise as healing progresses.
  • In general, full recovery from endometriosis surgery can take several months – longer if major organs were affected by extensive disease growth prior to treatment.

Key Takeaway:

  • Endometriosis is a painful condition where the tissue lining the uterus grows outside of it.
  • Surgery is one of the most effective treatments for endometriosis symptoms, and there are different types available depending on the severity and location of the endometrial tissue growth.
  • Laparoscopy is a minimally invasive surgery that is commonly used, while laparotomy and hysterectomy may be necessary for more severe cases.
  • Patients should discuss their treatment options with their doctor before making any decisions.
  • Surgical intervention should be considered a last resort after other treatments have been explored.
Frequently asked questions
  1. Is endometriosis surgery a major surgery?
    Yes it is a major surgery because it involves large abdominal incisions
  2. Can you have a baby after endometriosis surgery?
  3. Is endometriosis curable?
    No, there is no cure for endometriosis as of now.
  4. Can endometriosis return after surgery?
    Yes endometriosis can return after surgery if not completely removed in surgery
Reference
  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5635831/#:~:text=Endometrioma%20resection%20increases%20pregnancy%20rates,be%20done%20with%20great%20care.
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8628449/
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8127059/
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4279262/
Dr Purva Singh
MBBS MS OBGYN
IVF Specialist