Electrosurgery for endometriosis is a style of surgery that involves using controlled electrical currents to alter tissue. It produces the same results as other surgical styles but is often preferred for its versatility and bleeding control.
Surgery is currently the only way to diagnose endometriosis definitively and to remove endometrial cells outside of the uterus. Your doctor will recommend one of two surgical procedures: laparoscopy or laparotomy.
Laparoscopy, or “keyhole surgery,” involves making small incisions in your abdomen to insert a specialized viewing tool called a laparoscope. It’s the
Laparotomy, or “open surgery,” involves making a large incision in your abdomen to allow a full view of your organs. A laparotomy is a major surgery that can come with more complications and a longer healing time than laparoscopy.
Surgeons may select the electrosurgery method for either procedure. Electrosurgery involves using tools that release a controlled electrical current to create a variety of surgical effects, such as cutting, drying, clotting, and destroying tissue.
The distance between the electrosurgical tool and the tissue and the frequency of the electrical current determine the effect of electrosurgery. For example, a low frequency can produce a pure cut with almost no charring, while a higher frequency can noticeably coagulate and char the tissue it comes in contact with.
Electrosurgery is not the same as electrocautery. In electrosurgery, the electricity enters your body through the surgical electrode and causes an effect. In electrocautery, an electrical current is used to heat an instrument, and the heat creates the surgical effect.
The overarching goal of endometriosis surgery is to verify that endometriosis is present and destroy bundles of cells that are causing pain and other symptoms.
Electrosurgery offers several benefits in endometriosis procedures. In fact, it’s the most commonly used form of surgical energy across multiple medical fields due to its low cost, wide availability, and versatility.
Electrosurgery offers surgeons a “one-stop shop” approach. Rather than using several different instruments to sample or remove endometriosis tissue, surgeons can use an electrosurgical unit and change its effect on tissue simply by adjusting the electrical frequency.
In general, electrosurgery offers benefits such as greater precision, better bleeding control, and shorter surgery times than more traditional methods.
Your preparation for endometriosis surgery will be the same regardless of which style of surgery your doctor chooses.
You’ll receive instructions on whether you should stop taking any current medications before surgery, whether you should fast before surgery, and when or if you should take a shower.
Your surgical team may also ask you to remove any jewelry and nail polish to ensure there’s no interference with the machines that monitor your vitals. Removing jewelry and other metal-containing items can also help prevent unintentional conduction of electrical currents from electrosurgical units.
Before you head to your surgical appointment, you may need to arrange for transportation for after the procedure if your doctor places you under driving restrictions.
Even though you’ll likely be asked to wear a surgical gown during the procedure, wearing loose-fitting, comfortable clothing on the day of surgery is recommended.
For most people, electrosurgery for endometriosis is done through a laparoscopic procedure.
An anesthesiologist gives you an injection to induce general anesthesia, which is maintained along with your oxygen levels through a tube in your windpipe called an endotracheal tube.
Once you’re fully under anesthesia, the surgical team sterilizes your abdomen with a surgical scrub to reduce the risk of infection at the incision sites.
Your surgeon then makes a small incision, typically below your belly button. They insert the laparoscope and inflate your abdominal cavity with carbon dioxide gas to allow them space to maneuver and to provide the best possible visual.
Once the laparoscope is in place and your surgeon has identified suspected endometriosis sites, they can use various electrosurgical tools to sample the tissue, remove or destroy lesions, and break through adhesions (scar tissue caused by endometriosis).
They may need to make additional small incisions in your abdomen to use these tools.
At the end of the procedure, your surgeon will close the openings with stitches or surgical staples.
If you have a laparotomy instead of a laparoscopy, your surgeon will make one large opening across your midline rather than multiple small incisions, and no gas will be needed to inflate your abdominal cavity since it will be exposed for viewing.
Depending on the time and length of your surgery, you might go home the same day or the day after a laparoscopy procedure.
Regardless of the surgery style, it’s natural to feel tired for several days after you get home. Soreness at the incision sites is expected, and many people experience sharp pains in their upper body or back from leftover carbon dioxide, which causes pressure before it dissipates.
Laparotomy procedures often require a longer postoperative hospital stay to ensure your comfort level, watch for complications, and closely monitor your surgery site.
One of the most common complications of electrosurgery — though it’s rare overall — is the appearance of unrecognized burns due to various equipment failures and improper techniques.
Burns can be subtle and difficult to identify on internal tissue, so they may go unnoticed until they cause complications after surgery.
Delayed bleeding and scarring and loss of skin pigmentation
And you’re not the only one facing possible risks during electrosurgery for endometriosis. The surgical team is also at risk for rare complications from using electrosurgical equipment, such as:
- smoke inhalation
- infectious disease transmission
Endometriosis surgery, including electrosurgery, can effectively relieve pain and other symptoms of endometriosis. But the results are often temporary.
Up to 80% of people develop pain again within 2 years of surgery.
Not all endometriosis lesions can be easily identified during surgery. Lesions that aren’t visible during a procedure can grow and become a new source of discomfort.
Electrosurgery for endometriosis is a surgical style, not a surgical procedure. It involves using electrical currents to cut, clot, and destroy tissue.
Your surgeon can use electrosurgery during open surgery or laparoscopy, the most common surgical method used in the diagnosis and removal of endometriosis.
Electrosurgery is associated with shorter surgery times, greater precision, and better bleeding control. But complications, including unrecognized surgical burns, are possible.