Laparoscopic Treatment of Endometriosis
Endometriosis within the pelvis can be treated laparoscopically, resulting in significant improvement in pelvic pain and other symptoms. Small superficial endometriotic lesions can be burned off (also called fulguration), but for deeply infiltrating implants or larger implants, actual resection of the implants is superior. If the endometriotic implant is on or near a vital structure such as your intestines, bladder or ureter, excising it is safer since there is no risk for burning these important organs. Endometriomas, which are ovarian cysts due to endometriosis, are almost always completely excised.
For women who have never had a prior laparoscopy we will usually excise at least one lesion in order to send it to the pathologist to confirm the diagnosis.
The procedure:
A laparoscopic camera is introduced through the navel in order to see inside. The abdomen and pelvis is thoroughly inspected, and depending on the extent and location of the endometriosis, 1-2 additional 5mm ports are placed in the right and left lower areas of the abdomen. The endometriotic lesions are then burned or excised. Women with extensive endometriosis often also have adhesions (or scar tissue) within the pelvis, and these can be treated at the same time.
Patients are able to go home the same day of surgery, and recovery time is only a few days. Surgical results are further enhanced by postoperative use of medical suppression of endometriosis such as birth control pills or Depo-Lupron.