Laparoscopic Surgery for Endometriosis

Overview

Endometriosis growths (implants) are abnormal growths of endometrial tissue outside of the uterus lining - i.e., along the ovaries, fallopian tubes, bowels, or other abdominal organs. The misplaced tissue not only causes pain and heavy bleeding for women during menstruation, but can moreover develop into scar tissue, which can result in infertility. Women with endometriosis typically experience pain the abdomen, pelvic area, or lower back, however some women have no apparent symptoms. In fact, difficulty in conceiving (infertility) may be the very first sign of endometriosis. While the cause remains unknown, one of the key ways to diagnose and treat endometriosis is laparoscopy or laparoscopic surgery.

What is Laparoscopic Surgery?

Laparoscopic surgery - also known as keyhole surgery, minimally invasive surgery (MIS), and Band-Aid surgery - is a surgical technique that uses small incisions to insert a lighting instrument into the abdominal or pelvic cavity. Compared to open surgery - which entails larger incisions - laparoscopic surgery offers the advantages of decreased hemorrhaging, decreased pain, and shorter recovery periods.

In the case of infertility, a laparoscope is used to diagnose endometriosis, followed by laparoscopic surgery to remove any visible endometriosis implants and scar tissue. However, some growths may remain hidden from view, and thus a negative diagnosis is never 100% certain.

Laparoscopic surgery has proven effective in improving the chances of conception in some instances of endometriosis. For example, for moderate to severe cases of endometriosis, fertility often improves with surgery, however research has not shown significant success for treating infertility with laparoscopic surgery in cases of mild endometriosis. For severe cases of infertility due to endometriosis, in vitro fertilization (IVF) - an assisted reproductive technology - is often recommended instead of surgery.

More about Laparoscopes

Minimally invasive surgery uses TV monitors to view an enlarged image of the surgical area, which is viewed by the key piece of equipment in this type of surgery: the laparoscope.

During surgery the abdomen area is inflated, or 'insufflated,' by carbon dioxide gas in order to elevate the abdominal wall above the body's internal organs and thereby create a viewing and working area.

There are two types of laparoscopes. The first is a rod lens system connected to a video camera; the second is a digital laparoscope where the rod lens system is replaced by a charge-coupled device (a device for the movement of electrical charge) on the end of the laparoscope. A fiber-optic cable system in conjunction with a light source is used to illuminate the operative field, and it is inserted into the body via a soft, flexible tube called a cunnula.

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