Endometriosis & Laparoscopic Surgery
Endometriosis is a condition that occurs when the tissue that normally lines the uterus (endometrium) is found outside of the uterus. It may move into other parts of the pelvic area such as the ovaries, bowels or behind the uterus. This tissue responds to the hormones that regulate your monthly menstrual cycle. Endometriosis is a common health problem, and in some cases it can be painful and interfere with your daily life.
During your period, this endometrial tissue swells and bleeds as it sheds from the lining to be released in the menstrual flow. When the tissue is growing in other areas, this swelling causes discomfort and may form scar tissue. There is no known cause of this condition, but it has a tendency to run in families.
Symptoms of Endometriosis
The symptoms of endometriosis may include:
- Painful cramps
- Pelvic or back pain
- Pain with sex
- Changes in or pain during bowel movements
- Painful or increased frequency of urination
Diagnosis of Endometriosis
Endometriosis will likely be suspected after a history of the patient’s symptoms is taken and an examination is performed. This diagnosis is typically confirmed through screening with an ultrasound or MRI or a diagnostic laparoscopy.
Treatment of Endometriosis
Depending on your symptoms, treatment may include medications that reduce pain or medications that control your hormones. These conservative methods are often very effective in relieving symptoms, especially in milder cases of endometriosis. However, in more moderate to severe cases, surgery may be required to remove the excess tissue.
Laparoscopic Surgery for Endometriosis
Surgery for endometriosis is usually performed laparoscopically, using tiny incisions and the assistance of a camera. Dr. Rehder has been performing laparoscopy with use of laser removal of endometriosis for more than 25 years.
During this minimally-invasive procedure, the laparoscope, which is a thin tube, is inserted through a tiny incision to allow the doctor to examine the area. The surgical instruments are then inserted through additional tiny incisions to thoroughly remove the endometrial tissue.
Laparoscopy is much less stressful, both physically and psychologically, for the patient and it usually involves fewer complications than traditional open surgery. Laparoscopy is often performed as an outpatient procedure.
Risks of Laparoscopy
Risks from laparoscopic procedures are noticeably less than the possible risks of open surgery. They do exist, however, as noted below, and should be discussed with the surgeon prior to undergoing laparoscopy. Potential risks include:
- Excessive bleeding from the incisions
- Damage to an organ or blood vessel
- Allergic reaction to medications or anesthesia
Recovery from Laparoscopy
Recovery from laparoscopy is much quicker than from traditional surgery. The patient usually returns home the same day, and can resume normal activities within a few days. The patient is generally advised to avoid strenuous exercise or activity for about a week and to avoid drinking carbonated beverages for a day or two to prevent gas pains and vomiting. After laparoscopy, the patient may experience one or more of the following symptoms, none of which is serious, and all of which should disappear after a few days.
- Bruising around the incision site
- Pain at the incision site
- Irritation, achiness or pain in the area
- Crackling sound if the skin near the stitches is rubbed due to gas leakage
More rarely, dangerous symptoms may indicate the presence of infection or other complications. The physician should be contacted immediately if the patient develops:
- An area of redness or swelling around the incision(s)
- Bleeding or drainage from the stitches
- Severe belly pain