Laparoscopic surgery is a minimally invasive procedure that is used to diagnose endometriosis. It is also used to remove endometriosis lesions or scar tissue. It is sometimes called conservative surgery.
Some people experience pain relief or fertility improvements after lesions or scar tissue are removed. Laparoscopic surgery may be recommended if other methods, such as pain medicines or hormone therapy, are not reducing symptoms. Laparoscopic surgery is also used to address ovarian cysts. This procedure is called a cystectomy.1
How does laparoscopic surgery help manage endometriosis?
A laparoscopy is a minimally invasive surgical procedure that involves inserting a small, thin, camera-containing device into the abdomen to view the structures inside. This device is called a laparoscope. It sends real-time footage back to the surgeon performing the procedure so they can identify and assess any issues.
Your surgeon will look for endometriosis lesions within your pelvis. If they see anything abnormal, including potential endometriosis patches, they will take a small sample of this tissue and send it to a pathologist for more testing. This is called a biopsy. A pathologist is someone who is trained in looking at tissues underneath a microscope to diagnose different conditions.2,3
Biopsies are often performed during a person's first laparoscopic surgery to definitively diagnose endometriosis. However, even if you have had previous biopsies and your surgeon is confident you have endometriosis, they still may take additional biopsies. This is to find or rule out any other issues.
The location of the incision can depend on what structures inside the body your doctor is trying to get a closer look at. The procedure is performed by a surgeon. This may or may not be your gynecologist, depending on their training and specialty. The procedure is usually performed under general anesthesia, which means the person undergoing the surgery is asleep. The abdomen is also filled with gas during laparoscopic surgery to allow for better viewing of the internal structures.2,3
If your surgeon finds endometriosis lesions or scar tissue (adhesions) that need to be addressed, they will try to remove or destroy them. In some cases, these lesions may be able to be removed. This process is called an excision. During an excision, a lesion or scar tissue will be cut and removed from the body.1,4,5
In some cases, a lesion or scar tissue may be removed using extreme heat or energy. When high heat is used, this is called ablation or coagulation. Lesions can also be melted away and destroyed using lasers (vaporization) or electrical current (fulguration).1,4,5
Your surgeon will tell you what procedure they plan to use during your laparoscopic surgery and how it may impact your recovery. When addressing a cyst (cystectomy), the mass may be cut out, partially removed, or drained.1,4,5
What happens after laparoscopic surgery?
Many people go home the same day as their surgery. This is referred to as an outpatient procedure. However, depending on what occurred during your procedure, it may be necessary for you to stay overnight.1-3
After the procedure, you may feel sleepy or uncomfortable from any remaining gas inside your abdomen. You may also feel sore at your incision site. Many people are able to go back to their normal activities within a few days of the procedure.1-3
What are the possible side effects of laparoscopic surgery?
Since laparoscopic surgery is minimally invasive and only requires a small incision, it has fewer risks when compared to open surgery or more invasive procedures. The main risks of this procedure for the treatment of endometriosis include:1
- Scar tissue formation after surgery (adhesions), which can create similar symptoms as before the procedure
- Damage to structures within the pelvis, such as the bladder, bowel, or uterus (especially if lesions were addressed on these structures)
- Pelvic infections
- Uncontrolled bleeding
These are not all the possible side effects of laparoscopic surgery. Talk to your doctor about what to expect during treatment with laparoscopic surgery. You also should call your doctor if you have any changes that concern you during treatment with laparoscopic surgery.