Endometriosis is a complex condition that can cause a range of symptoms, from abnormal and painful menstruation to infertility. Unfortunately, this condition is relatively common, affecting 10% of women globally(1). Doctors use various diagnostic methods, such as ultrasound and MRI, to identify the endometriotic lesions, adhesions and endometriosis cysts of the ovary before exploring treatment options. There are a range of treatments for endometriosis, such as surgery (the team at Sydney Endometriosis performs both laparoscopic and robotic surgery); there is also more than one type of surgery for endometriosis. So, what are common surgeries for endometriosis?
What Is Endometriosis Surgery
Various types of endometriosis surgery are performed to remove endometriotic growths. There are two main types of surgery for endometriosis: laparoscopy or robotic surgery with or without hysterectomy. The doctor will select the appropriate surgery based on several factors to ensure the best results.
Why Endometriosis Surgery is Performed
Endometriosis can have wide-reaching effects on one’s health and well-being. Doctors typically perform endometriosis surgery when the symptoms are severe and impacting the person’s quality of life (QoL), and less invasive treatments have not proven successful. The operation is intended to alleviate pain, improve the QoL, and, in some cases, improve fertility.
Types of Surgery for Endometriosis
Doctors base their decision on which type of endometriosis surgery they will perform on the type (superficial or deep endometriosis or endometriosis cysts), location (reproductive tract and/or bowel and/or bladder), age and fertility plans of the patient, and severity of the endometriosis.
Laparoscopy vs Robotic surgery
Doctors typically start with the least invasive approach based on the results of diagnostic imaging tests. A laparoscopy or robotic approach can also serve as a diagnostic tool, ensuring the most accurate and precise diagnosis when other imaging methods do not provide a clear view of the endometriosis. Whether your gynaecologist surgeon chooses laparoscopy or robotic approach depends on the training, expertise and skill mix of your surgical team.
A laparoscopy is a minimally invasive procedure performed by inserting a thin tube (a laparoscope) with a camera into a small incision near the navel. This provides a clear view of the pelvic area, allowing the surgeon to remove or destroy the endometrial implants.
Robotic surgery is also minimally invasive procedure and once the robotic arms have been placed in position, the surgeon sits comfortably at the console and operates under 3D view of the pelvis.
Recovery time for both approaches is significantly shorter than open pelvic surgery, with most patients recovering within 14 days.
Hysterectomy
Hysterectomy is a good operation for heavy menstrual bleeding and is a cure for this. Hysterectomy however is not a good operation for pelvic pain. If you have coexisting adenomyosis with your endometriosis, then your surgical team will discuss the merits and risks of endometriosis surgery with or without hysterectomy. These procedures can be both done either laparoscopically or robotically. The most important consideration when deciding about hysterectomy at the time of endometriosis surgery is that the patient’s needs to understand that their pelvic pain may well not go away after hysterectomy and persist. You will need to have a very considered discussion with your gynae surgeon and in doing so it’s important to have clear expectations and goals in relation to the surgery.
Not only can pelvic pain persist post hysterectomy but endometriosis can recur after hysterectomy.
Each woman’s experience of endometriosis varies depending on its location, severity, and their symptoms. Therefore, it is crucial to create a treatment plan tailored to the individual based on the impact of these symptoms on their QoL and fertility plans. Surgery is not the only option; in many less severe cases, hormone-based treatments can successfully manage the symptoms of endometriosis. If you have been diagnosed with endometriosis, it is critical to take the time to discuss your options with your doctor. You’ll need to weigh the risks, benefits, and alternatives before pursuing surgery to ensure you are comfortable with your choices.
