A laparoscopy is a surgical procedure that may be used to diagnose and treat various conditions, including endometriosis.
During a laparoscopy, a long, thin viewing instrument, called a laparoscope, is inserted into the abdomen through a small, surgical incision. This allows your doctor to view tissue or take a tissue sample, called a biopsy. They may also remove cysts, implants, and scar tissue caused by endometriosis.
A laparoscopy for endometriosis is a low-risk and minimally invasive procedure. It’s typically performed under general anesthesia by a surgeon or gynecologist. Most people are released from the hospital on the same day. Overnight monitoring is sometimes required, though.
Who should have a laparoscopy?
Your doctor may recommend a laparoscopy if:
- You regularly experience severe abdominal pain believed to be caused by endometriosis.
- Endometriosis or related symptoms have continued or reappeared following hormone therapy.
- Endometriosis is believed to be interfering with organs, such as the bladder or bowel.
- Endometriosis is suspected to be causing infertility.
- An abnormal mass has been detected on your ovary, called ovarian endometrioma.
Laparoscopic surgery isn’t suitable for everyone. Hormone therapy, a less invasive form of treatment, may be prescribed first. Endometriosis that affects the bowel or bladder may require further surgery.
How to prepare for a laparoscopy
You may be instructed to not eat or drink for at least eight hours leading up to the procedure. Most laparoscopies are outpatient procedures. That means you don’t need to stay at the clinic or hospital overnight. However, if there are complications, you may need to stay longer. It’s a good idea to pack a few personal items just in case.
Arrange for a partner, family member, or friend to drive you home and stay with you after your procedure. General anesthesia can cause nausea and vomiting, too. Having a bag or bin ready for the car ride home is a good idea.
You might be instructed not to shower or take a bath for up to 48 hours following a laparoscopy to allow the incision to heal. Showering right before the procedure might make you feel more comfortable.
How the procedure is done
You’ll be given a general or a local anesthetic prior to the surgery to induce either general or local anesthesia. Under general anesthesia, you’ll fall asleep and not feel any pain. It’s usually administered through an intravenous (IV) line, but may also be given orally.
Under local anesthesia, the area where the incision is made will be numb. You’ll be awake during the surgery, but won’t feel any pain.
During the laparoscopy, your surgeon will make an incision in your abdomen, typically under your bellybutton. Next, a small tube called a cannula is inserted into the opening. The cannula is used to inflate the abdomen with gas, usually carbon dioxide or nitrous oxide. This helps your surgeon to see the inside of your abdomen more clearly.
Your surgeon inserts the laparoscope next. There’s a small camera on the top of the laparoscope that allows them to see your internal organs on a screen. Your surgeon may make additional incisions to get a better view. This can take up to 45 minutes.
When endometriosis or scar tissue is found, your surgeon will use one of several surgical techniques to treat it. These include:
- Excision. Your surgeon will remove the tissue.
- Endometrial ablation. This procedure uses freezing, heating, electricity, or laser beams to destroy the tissue.
Once the procedure is finished, your surgeon will close the incision with several stitches.
What’s recovery like?
Immediately after the surgery, you might experience:
- side effects from the anesthetic, including grogginess, nausea, and vomiting
- discomfort caused by excess gas
- mild vaginal bleeding
- mild pain at the site of the incision
- soreness in the abdomen
- mood swings
You should avoid certain activities immediately after your surgery. These include:
- intense exercise
- sexual intercourse
It can take a week or more before you’re ready to return to your regular activities.
You should be able to resume having sex within two to four weeks following the procedure, but check with your doctor first. If you’re planning to get pregnant, you can start trying again once your body has recovered.
Your first period after the surgery may be longer, heavier, or more painful than usual. Try not to panic. Your body is still healing on the inside, even if you feel better. If pain is severe, contact your doctor or emergency medical care.
After your surgery, you can ease the recovery process by:
- getting enough rest
- eating a mild diet and drinking enough fluids
- doing gentle movements to help eliminate excess gas
- taking care of your incision by keeping it clean and out of direct sunlight
- giving your body the time it needs to heal
- contacting your doctor immediately if you experience complications
Your doctor may suggest a follow-up appointment between two and six weeks after surgery. If you have endometriosis, this is a good time to talk about a long-term monitoring and treatment plan and, if necessary, fertility options.
Is it effective?
Laparoscopic surgery is associated with decreased overall pain both at 6 and 12 months post-surgery. Pain caused by endometriosis may eventually reappear.
The link between endometriosis and infertility remains unclear. However, endometriosis affects up to 50 percent of infertile women, according to the European Society of Human Reproduction and Embryology.
In one small study, 71 percent of women under the age of 25 who underwent laparoscopic surgery to treat endometriosis went on to get pregnant and give birth. Conceiving without the use of assisted reproductive technologies is more difficult if you’re over the age of 35.
For women seeking treatment for infertility who experience severe endometriosis, in vitro fertilization (IVF) may be suggested as an alternative to laparoscopic surgery.
Are there any complications of having this surgery?
Complications of laparoscopic surgery are rare. As with any surgery, there are certain risks. These include:
- infections in the bladder, uterus, or surrounding tissues
- uncontrolled bleeding
- bowel, bladder, or ureter damage
Contact your doctor or emergency medical care if you experience any of the following after laparoscopic surgery:
- severe pain
- nausea or vomiting that doesn’t go away within one or two days
- increased bleeding
- increased pain at the site of the incision
- abnormal vaginal discharge
- unusual discharge at the site of the incision
Laparoscopy is a surgical procedure used to diagnose endometriosis and treat symptoms such as pain. In some cases, laparoscopy may improve your chances of getting pregnant. Complications are rare. Most women make a full recovery.
Talk to your doctor to find out more about the risks and benefits of laparoscopic surgery.