Surgical Treatment for Endometriosis

If endometriosis is suspected, laparoscopic surgery may be planned to diagnose and treat the condition. In a laparoscopy, which is also a diagnostic procedure, the surgeon excises any visible endometriotic implants and scar tissue. This minimally invasive surgery, which takes place in the hospital, requires only small incisions and a relatively short recovery time.

The surgeon makes a series of small incisions in the abdomen and inserts a thin scope with a light and a camera at the tip. The surgeon uses the scope, which magnifies the doctor’s view, to look for endometrial implants and scar tissue throughout the abdomen. They may look for endometriosis in the space behind the uterus (called the cul-de-sac) and on organs such as the uterus, bladder, ovaries, fallopian tubes, bowel, and rectum. Surgical instruments are used to remove any implants or scar tissue that’s found, and the tissue is then sent to a laboratory. A pathologist then analyzes it to confirm the diagnosis.

You may go home on the day of the procedure, and you can expect to return to your normal activities within 10 to 14 days.

Hysterectomy, the surgical removal of the uterus, is sometimes used to treat endometriosis and pelvic pain. The procedure may be particularly important for those who also have adenomyosis—in which the endometrial lining grows into the muscular wall of the uterus—or fibroids. Either condition can cause pelvic pain during menstruation as well as heavy or irregular bleeding. Your surgeon excises any endometriosis found during the hysterectomy, as untreated endometriosis may continue to cause significant symptoms after hysterectomy.

Most of the time, it is not necessary to remove the ovaries, which is done via a procedure called an oophorectomy. After a hysterectomy, your period stops, but only removal of the ovaries causes the body to enter menopause. This can lead to symptoms of menopause, including hot flashes and bone density loss, no matter your age. Your doctor will help you decide whether this surgery is appropriate for you and, if so, develop a plan to help you manage the symptoms of menopause.

Hysterectomy can be performed in several ways. Doctors can perform a laparoscopic hysterectomy, a robotic laparoscopic hysterectomy, or conventional open surgery. Open surgery is rarely necessary. For most hysterectomies, you can go home the same day, and recovery typically takes two weeks. For open surgery, you may need to stay in the hospital at least one night, and recovery can take four to six weeks.