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Laparoscopic surgery is the most common procedure performed to diagnose endometriosis and remove endometrial cysts—noncancerous masses that contains particles of endometrial tissue. Depending on the patient and the severity of her endometriosis, laparoscopic surgery can be an extremely effective treatment. The surgery is minimally invasive and usually performed on an out-patient basis. Patients often experience immediate relief from pain, and in many cases, increased fertility is possible. Results from the surgery can be permanent, but many women do experience recurrences and require further treatment.
During laparoscopic surgery for endometriosis, a small incision is made at the base of the naval. The abdomen is filled with gas—usually carbon dioxide—which inflates the belly, allowing the doctor to see more easily once he has inserted the laparoscope, a small, lighted instrument with a camera that enables the surgeon to examine his patient's uterus and ovaries without doing open surgery. Often, laparoscopic surgery is done to diagnose endometriosis. If an endometrioma is found, it may be removed. To do this, the surgeon will make one or more additional incisions in the abdomen, through which he can insert his surgical instruments.
A gynecologist might recommend laparoscopic surgery for endometriosis if his patient experiences abnormal pain associated with the menstrual cycle, infertility, or other symptoms of endometriosis. The advantage of laparoscopic surgery for endometriosis is that it is a relatively short procedure, usually taking 30 to 45 minutes. It can be done on an outpatient basis, and the recovery time after the surgery is typically only a few days to a week. For women who experience abdominal pain, laparoscopic surgery can provide immediate pain relief in many cases, whereas an alternative treatment, such as hormone therapy, may not.
For women seeking relief from pain associated with endometriosis, laparoscopic surgery is effective in 70 to 100% of women in the initial months after surgery. In 45% of women, symptoms recur in the first year after surgery. The more advanced the endometriosis is, the more likely it is for a woman to experience a recurrence of endometriosis or endometrial pain. During laparoscopic surgery for endometriosis, the surgeon can either drain or cut out part of an endometrioma, or he may completely remove the endometrial cyst. Many doctors recommend complete removal as the most effective method of relieving endometrial pain and for preventing endometriosis from returning.
Women whose infertility is associated with endometriosis have varying results after laparoscopic surgery for endometriosis. Laparoscopy seems to be less effective in mild cases of endometriosis. However, in moderate to heavy cases, laparoscopic surgery for endometriosis can be helpful and may result in an increase in fertility. Other factors that heavily determine a woman's fertility after laparoscopic surgery for endometriosis include her age, the viability of her eggs, and her risk for miscarriage.