Laparoscopic Surgery for Endometriosis


What is Endometriosis?

Eendometrium is the tissue that forms the inner lining of the womb. However, sometimes these tissues grow outside the uterus and attach themselves in places such as the fallopian tubes, ovaries, bowels, exterior of the uterus or other internal parts. During menstrual cycles theses tissues break down due to hormonal changes resulting is scar tissue and painful adhesion. Thus, such a condition is known as endometriosis where the intensity of the symptoms varies among different individuals.

Image Source: en.wikipedia.org

Risks of Endometriosis

Some people are more prone to develop endometriosis than others, they include:

  • Symptoms in women between the age of 25 to 40 years (sometimes they might begin in the teenage years)
  • Condition is common among women who may be related

Certain situations limit the possibility of having endometriosis:

  • Consumption of oral contraceptive pills acts as a safeguard against endometriosis and the effect of the pill lasts up to one year after stopping its intake
  • Women who have undergone menopause in the past rarely develop the condition due to the lack of the female hormone oestrogen which is a requisite for endometriosis

Symptoms of Endometriosis

  • Pain: The pain usually starts before the periods and continues till the end of the cycle. It is severe and the intensity is much more than the pain which women experience during their menstrual cycle.
  • Pain in the lower abdomen: There is a consistent pain in the lower abdomen, but the pain seems to get worse during menstruation.
  • Painful sex: Women may experience deep pain during sex which might even last for a few hours.
  • Reduced fertility: Clumps of the endometrial tissues may block the fallopian tube (passage through which the egg moves from the ovary), thus making it difficult for women to conceive.
  • Bleeding: Sometimes women may bleed in between their periods or while passing faeces or urine.

Complications of Endometriosis

Endometriosis is a non cancerous condition and its progress rate varies from a person to another. For some, it may heal on its own or become worse and for others it may remain the same. However, this does not rule out the chances of women suffering from blockage in the bowel or tube of the kidney to the uterus due to endometriosis.

Image Source: en.wikipedia.org

Why is treatment needed?

Following are the aims of the treatment:

  • Improve cases of heavy periods
  • Improve the symptoms
  • Reduce chances of infertility
  • Reduce the pain

Laparoscopic surgery for Endometriosis

Laparoscopy is a surgery that is meant for examination and treatment. It is done by making a small incision near the belly button and the abdomen is filled with CO2 gas so that the abdomen lifts away from the internal organs. This is done to give a better view and allow the surgeon to perform the surgery efficiently. A thin lighted tube is put through the incision and sometimes doctors also place a camera for better observation. This procedure is used in case of fibroids, cysts, adhesions or infections.

Image Source: en.wikipedia.org

How does Laparoscopy help to treat endometriosis?

The doctor may suggest a laparoscopy for the following reasons:

  • Diagnosis: Laparoscopy is the only way to determine endometriosis. Symptoms of the condition are not the same for everyone and in some cases the problems can remain hidden or misdiagnosed for a very long time. Thus, in order to view the condition accurately a laparoscopy may be suggested.
  • Removal: The same surgery may be used to remove cysts, implants or scar tissues that may be causing pain and infertility in women.

Procedure

  1. Surgery is performed by a surgeon or gynecologist
  2. Commonly, general anesthesia is used but people can stay awake if they choose the use of spinal or local anesthetic
  3. Carbon dioxide or nitrous oxide gas is injected to inflate the abdomen in order to push the abdominal wall away from the internal organs
  4. Small incision is made near the navel
  5. Surgeon inserts a laparoscope through the incision
  6. He/she then examines the organs for presence of any structures
  7. The procedure lasts for about 30-45 minutes
  8. If a scar tissue is found the surgeon removes it by incision or by using laser beam or electric current
  9. Then the incision is closed with the help of some stitches that may result in minimum or no scarring

Time taken to heal

A laparoscopic surgery requires a patient to stay at the hospital for a day. The individual can return to regular work after a week or more.

Risks of Laparoscopic surgery

  • Damage to bowel , bladder or uterus
  • Uncontrolled bleeding which leads to the need of a larger abdominal incision
  • Pelvic infection
  • Scar tissue formation after the surgery

Advantages of Laparoscopy

  • Reliefs from pain, but to ensure longer periods of pain relief hormone therapy should be used after the surgery as there are chances of the condition to recur
  • Can improve fertility among women who could have encountered problems to conceive a child due to blockages in the fallopian tube that do not allow the movement and fertilization of the female eggs or ovum

When to visit a doctor?

As mentioned above, the symptoms are not reliable as they occur in varying intensities for different people. In order to diagnose and treat endometriosis correctly, it is important to consult a doctor as soon as the individual experiences even the slightest symptoms.

Endometriosis Pictures:

Possible Locations. Image Source: en.wikipedia.org

 

Image Source: en.wikipedia.org

 

Image Source: en.wikipedia.org

 

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