Endometriosis is an inflammatory condition in which endometrial-like tissue grows outside the uterus. The most common surgery types for this condition are laparoscopy, laparotomy, and hysterectomy.
Endometriosis is often painful. It can cause infertility, excessive bleeding, and pain with intercourse. There is currently no cure for endometriosis. However, doctors can treat the condition with hormonal and nonhormonal medications, as well as surgery.
This article explores surgical treatment options for endometriosis, including laparoscopy, laparotomy, and hysterectomy, what to expect after surgery, and possible risks associated with each procedure.
If the pain caused by endometriosis is severe and medication is not working well to relieve it, a healthcare professional
A healthcare professional may also recommend surgery if a person is experiencing infertility.
There is currently no cure for endometriosis. However, surgery may help to remove or destroy areas of endometriosis tissue to ease symptoms and help fertility.
Surgery is the only way to definitively confirm whether a person has endometriosis. However, a doctor may make a presumptive diagnosis based on a person’s medical history and symptoms.
Surgical options for endometriosis include:
A laparoscopy is a minimally invasive surgery. A surgeon creates incisions in a person’s abdomen to insert a camera. The surgeon uses the camera to find endometrial tissue and remove it.
There are several methods of removing endometrial tissue. These include:
- Excision: This technique is where a surgeon directly
cuts outendometriosis tissue.
- Ablation: This technique involves a surgeon destroying endometriosis tissue using either a laser, heating, electricity, or freezing.
Surgeons typically perform laparoscopic surgery as follows:
- The person receives general anesthesia.
- The surgeon makes two to four small incisions near the person’s belly button.
- After making incisions, the surgeon fills the person’s abdomen with carbon dioxide gas. This allows the surgeon to see the person’s internal organs.
- The surgeon then uses a laparoscope (a small camera) to examine the abdomen for scar tissue, endometriosis, and other abnormalities.
- The surgeon carefully removes the endometriosis tissue (including the tissue beneath the surface), leaving healthy organ tissues intact.
- After the procedure, the surgeon closes the incisions using either dissolvable stitches or glue. The incisions are then covered with bandages or other dressings to help prevent infection.
The person should be able to go home on the same day as their surgery. The procedure could take 30–60 minutes or longer, depending on the person and the severity of their condition.
Surgeons typically perform a laparotomy as follows:
- The person receives general anesthesia.
- The surgeon makes one large incision (rather than several small incisions) in the abdomen, typically below the bikini line. The incision can be as long as 15–20 centimeters.
- The surgeon removes the endometriosis tissue (or scar tissue) and closes the incision using special tools.
- Once the procedure is complete, the surgeon closes the muscles of the abdominal wall and the overlying skin using medical stitches.
A laparotomy is considered major abdominal surgery, and the person may need to stay in the hospital overnight after it.
During a hysterectomy, a surgeon removes the person’s uterus. A hysterectomy is the most common form of definitive endometriosis surgery. A surgeon can do it abdominally, laparoscopically, or vaginally.
The surgeon may also remove the person’s cervix, ovaries (oophorectomy), and fallopian tubes.
Deciding to undergo a hysterectomy is a serious decision. People who choose to have this surgery will no longer be able to carry a pregnancy.
People who undergo a vaginal or laparoscopic hysterectomy may be able to go home on the same day of their surgery. However, those who have an abdominal hysterectomy typically stay at the hospital overnight.
Recovery times are different for everyone depending on the severity of the endometriosis and their chosen treatment method.
Most people feel relief after endometriosis surgery. However, there is a chance that the pain will come back. According to the American College of Obstetricians and Gynecologists (ACOG), up to 8 in 10 individuals experience pain and recurring symptoms within 2 years of surgery.
People who have laparoscopic excision surgery tend to recover faster than those who have a laparotomy or hysterectomy.
After laparoscopy, it is common to feel tired and uncomfortable for a few days following the procedure. The incision site will feel sore, and the person may have back or shoulder pain. These should go away within a few hours or days.
Recovery from a laparotomy can take 6 weeks or longer in some cases. People who undergo a laparoscopic or vaginal hysterectomy may need 3–4 weeks to recover. It takes 6–8 weeks to fully recover from an abdominal hysterectomy.
All procedures come with risks. Potential risks of surgical treatment include:
People should also be aware that there is a risk of continued pain from endometriosis even after surgery.
People who experience one or more of the following symptoms after their operation should seek immediate medical attention:
People should speak with their doctor if they are experiencing severe endometriosis symptoms that have not been resolved by medication or nonsurgical treatment.
- very painful menstrual cramps
- pain during or after sex
- painful bowel movements (including blood in stools)
- intestinal pain
- digestive issues (diarrhea, constipation, bloating, nausea)
People experiencing infertility due to endometriosis should also ask their doctor if surgical treatments are appropriate for them or if they will improve their chance of pregnancy.
A healthcare professional will be able to assess a person’s condition and advise on the best course of treatment.
Endometriosis is an inflammatory condition in which endometrial-like tissue grows outside the uterus.
Although there is currently no current cure, surgery may help manage symptoms and improve fertility.
While surgery may help to relieve pain, the ACOG estimates that endometriosis symptoms return in 40–80% of people after surgery.
People with endometriosis should speak with their doctor if they are experiencing symptoms, such as severe pain, and medication is not offering relief.