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Surgical Procedures for Endometriosis

Surgical intervention is the most aggressive treatment for endometriosis. Surgery may be recommended if you:
  • Do not respond to other treatment
  • Are older and feel you need to become pregnant more quickly
  • Have severe physical changes due to the disease
The two main surgical procedures used are:

Laparoscopy

Laparoscopy is a non-evasive procedure that is done through small incisions in the abdomen. A very small camera and surgical instruments are inserted through these small openings. This camera projects a picture of the inside of the abdomen onto a video screen. It lets the surgeon see any endometrial tissue that may be on the uterus, fallopian tubes, ovaries, lining of the pelvis, and other structures. Surgical instruments are inserted through other small cuts and are used to cut away or burn off endometrial growths and to divide scar tissue.

Hysterectomy

Generally considered the option of last resort, a hysterectomy is the surgical removal of the uterus. The ovaries and fallopian tubes may be removed at the same time, which is called a bilateral salpingo-oophorectomy. During the procedure, endometrial growths on other organs are also removed.
This is generally considered the most effective treatment for severe endometriosis. The ovaries play a critical role in the hormonal stimulation of endometriosis. The ovaries are usually involved in the actual disease. Because of this hysterectomy without removal of the ovaries often fails to be an effective treatment option.
After you have this surgery, you cannot become pregnant and will have all of the side effects of menopause if your ovaries are removed.

References

Endometriosis. The American College of Obstetricians and Gynecologists website. Available at: http://www.acog.org/~/media/For%20Patients/faq013.pdf?dmc=1&ts=20120817T0827507766. Published 2011. Accessed August 16, 2012.

Endometriosis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated. Accessed March 20, 2012. Accessed August 16, 2012.

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