Endometriosis is characterised by the development of tissue similar to that which lines the uterus, growing outside of the uterus. The symptoms accompanying this condition range from pain and irregular periods to infertility and more. There are various treatments for this condition, such as hormone-based medication and surgery in more severe cases. With time, however, there have been impressive advancements in surgical techniques. These techniques have been developed to be less invasive and more effective. So, what are the surgical options for endometriosis, and what do these state-of-the-art procedures involve?
How Endometriosis Surgery Has Evolved
Gynaecological surgery for endometriosis used to be painful and extensive, with a long recovery time. Since the 1980s, less invasive procedures have been introduced to reduce post-operative pain, shorten recovery time, and improve the success rate of such surgeries. Today, these minimally invasive techniques have been further enhanced, and women can benefit from state-of-the-art techniques such as natural orifice transluminal endoscopic surgery, robotic surgery, laparoscopy, and mini-laparoscopy. The gynaecological surgeon will select the surgery based on various factors, such as the size, location, and severity of the endometrial tissue.
When Is Endometriosis Surgery Necessary?
Surgery can be the first line approach however most clinicians tend to suggest surgery for women when other treatments have failed to provide relief from pain, regulate periods, and improve fertility. These treatments range from lifestyle self management strategies and pain management to hormone-based therapies such as oral contraceptive pills, intrauterine devices (IUD), contraceptive injections, contraceptive implants and gonadotropin-releasing hormones (GnRH). These treatments are also selected based on the patient’s QoL concerns, fertility goals and overall health.
State-of-The-Art Endometriosis Surgery
If your doctor recommends surgery for endometriosis, the following are potential procedures.
Natural Orifice Transluminal Endoscopic Surgery
A minimally invasive procedure, natural orifice transluminal endoscopic surgery requires specialised training and instruments and is not yet widely used; however, it is the next frontier in endometriosis surgery. This surgery is performed through an existing orifice, in this case through the vagina, to access the reproductive organs without the need for an incision in the abdominal wall.
Robotic Surgery
Robotic surgery uses cutting-edge technology to improve the surgeon’s flexibility and precision. During robotic surgery, a surgeon makes a small abdominal incision and guides robotic arms equipped with surgical instruments and a camera through the abdomen to view and remove endometrial lesions. This surgery tends to be more expensive due to the equipment involved; however, it is ideal for complex cases of endometriosis involving vital organs.
Laparoscopy
While not new, this minimally invasive concept informs other surgical methods for endometriosis, such as robotic surgery and mini-laparoscopy. A small incision is made near the navel through which the laparoscope (small camera) is inserted. This camera offers surgeons a view into the area, allowing them to accurately diagnose, locate, and remove the endometrial tissue. Because this method is minimally invasive, post-operative pain and recovery time are reduced, leading to a lower risk of complications.
Mini-laparoscopy
Similar to laparoscopy, mini-laparoscopy involves a smaller incision of 5mm or less. This method further reduces tissue trauma, pain, and scarring.
Advancing technology and surgical methods have made endometriosis surgery less invasive and more effective. With a range of options available, surgeries can be tailored to patient needs. As a result, recovery time and pain are reduced, and fertility is improved. If you are considering surgery for endometriosis, consult a gynaecological specialist to find the most appropriate approach. Proper treatment offers many women relief from endometriosis symptoms and enhances their quality of life.
