Endometriosis electrosurgery can help remove endometriosis adhesions and lesions, reducing the severity of symptoms and sometimes improving fertility. This procedure is also the only way to confirm a diagnosis of endometriosis.
Endometriosis is a relatively common gynecological condition that
A doctor may suspect endometriosis based on a person’s symptoms, but laparoscopic surgery is the
Read on to learn more about the types of endometriosis surgery, including what to expect and the risks and benefits.
Endometriosis surgery falls into
In people who want to become pregnant or preserve their fertility, surgery will focus on removing the endometrial-like tissue. This is the most common and conservative form of surgery.
The surgeon’s goal is to remove adhesions and lesions. Adhesions are bands of scar tissue that stick together when the endometrial-like tissue grows on the organs.
Doctors have many options for removing endometriosis, but there are no specific guidelines. Instead, a doctor will choose a treatment approach based on the risks and benefits of various procedures and the needs of the person having surgery. In most cases, they will choose the least invasive option.
The two most common general surgical approaches are:
- Laparoscopy: This minimally invasive procedure, which is also called keyhole surgery, involves a surgeon making a very small incision, often in the bellybutton. Through this, they will insert a scope with a camera to look for endometriosis lesions. If they find endometriosis, they will create another incision and use a tool to remove the tissue. In some cases, they will use a robot to assist in the surgery.
- Open: A surgeon will make a larger incision in the abdomen and manually remove any endometriosis tissue. This surgery usually has a longer recovery time, so most doctors prefer the laparoscopic approach.
People with endometrial-like tissue in many different locations throughout the body might need more complex surgery. This may involve an open procedure or several different surgeries.
Surgeons can use various techniques to remove endometriosis. One of the most common is
Removing the uterus (hysterectomy)
A hysterectomy removes the uterus along with the endometrial-like tissue, reducing the risk that endometriosis will return. It is only a viable strategy for people who do not want to have any or any more children and are prepared to go through menopause.
Removing the uterus does not eliminate the chance that endometriosis will recur. Even after a hysterectomy, endometriosis can grow back.
The success of endometriosis surgery varies and depends on the type of surgery, the severity of the endometriosis, and where it is in the body.
Sometimes, a surgeon is not able to remove all of the endometrial-like tissue at once. Even when they do, the tissue will likely grow back over time. A doctor may prescribe hormonal birth control to slow the growth of new endometrial-like tissue and reduce the need for future surgeries.
There are few specific guidelines offering information about when to choose endometriosis surgery. For this reason, many doctors recommend surgery only if a person has endometriosis-related infertility, or their symptoms do not get better with hormonal treatments.
Before having surgery, it is important that a person understand the risks and benefits. If a person does not have symptoms of infertility, there may be no reason to have surgery. Questions that it might be helpful to ask a doctor include:
- What type of surgery do you recommend?
- How likely is surgery to succeed?
- How long will recovery take?
- What are the risks of surgery?
- What are the alternatives to surgery?
Endometriosis surgery requires a person to have anesthesia, so they will need to avoid food and water before the procedure. A person will go to sleep during the surgery and wake up with no memory of it. They may have pain and feel confused or groggy from the anesthetic, but in most cases, they can go home the same day.
If the surgery is more complex or a person experiences complications, they may need to stay in the hospital. Recovery depends on the type of surgery, but a person can usually return to their normal activities fairly quickly. However, they may need to avoid exercise, heavy lifting, and other physical activities for several weeks.
The risks of endometriosis surgery depend in part on the type of surgery. For example, a person who has surgery to remove endometrial-like tissue from their bladder could sustain damage to the bladder.
Some of the most common risks include:
- needing additional surgery because surgery does not remove all of the tissue
- pain after surgery
- bleeding after surgery
- surgery that does not cure symptoms or improve fertility
Less common complications include:
- damage to organs such as the bladder, bowel, uterus, fallopian tubes, and ovaries
- severe bleeding
- allergic reaction to the drugs the person receives during surgery
- needing a hysterectomy
- anesthesia complications
Although it is extremely rare, the procedure can sometimes be fatal.
Some people with endometriosis may develop endometriomas, which are cysts on the ovaries that consist of endometrial-like tissue. Surgery to remove these can also damage the surrounding healthy ovarian tissue and reduce the ovarian reserve.
Endometriosis can be very aggressive. Although surgery often helps relieve the symptoms for some time and may increase fertility, endometriotic lesions can grow back. The
At present, there is
Hormonal therapy for endometriosis can help prevent a recurrence or reduce the severity of symptoms. This therapy may include birth control pills, progesterone, or gonadotropin-releasing hormone (GnRH). However, these therapies are not an option for someone who is trying to get pregnant.
Physical activity and omega-3 fatty acid intake correlate with a
Accessing endometriosis surgery can be difficult. Many people face long delays in diagnosis, with research suggesting that people wait an average of
The specific cost of surgery depends on various factors, including:
- who performs the surgery
- where a person has the surgery
- whether a person has insurance
- a person’s insurance copay
- whether insurance deems the surgery medically necessary
With insurance coverage, a person may pay little or nothing for endometriosis surgery. Without it, the cost can exceed tens of thousands of dollars.
Endometriosis is a chronic condition that can affect a person for the entirety of their reproductive years. Surgery, including endometriosis electrosurgery, may help relieve the symptoms and preserve fertility.
However, there is no cure, and a person with endometriosis will need long-term monitoring and hormonal treatment. An endometriosis specialist can help a person manage their condition, make fertility decisions, and choose appropriate surgical options.