The removal or excision of the endometriotic implants is known as laparoscopic excision of endometriosis. This procedure can be deemed as a conservative management of endometriosis. The main goal of any conservative surgery like this is to improve the symptoms on one hand and preserve the uterus, fallopian tubes and ovaries, to an extent, on the other. This procedure is usually conducted on women who wish to bear child in the future and those who have a milder form of the disease. Conservative surgery has been successful in minimizing the pain as 80% of the patients have reported improvement in the symptoms within 6 months of surgery. However, it does not cure endometriosis. Almost 40 to 80% of women suffer a recurrence of pain, all within 2 years of the surgery. It is for this reason medications are also referred along with the surgery to extend the period of pain free endometriosis.
Why choose laparoscopic endometrioma excision?
There are mainly two types of treatment options for endometriosis. These options include fulguration of endometriosis and resection or excision. Fulguration of endometriosis involves burning the endometriosis implants in order to completely destroy any chance of abnormal endometriosis implants. Resection or the excision of endometriosis is the removal of the endometriotic implants. Both of these procedures are done laparoscopically.
However, laparoscopic excision of endometrioma is much more effective than the fulguration procedure, since excision works well for deep infiltrating endometriosis. Moreover, an endometrioma should be completely removed from its site and not just burned or drained. It is because if the endometrioma is not removed there is an 88% chance that it will return again. If the endometrioma is more than 1 centimeter long, then it cannot be medically managed or drained. Removal is the only option.
The procedure of laparoscopic endometrioma excision
The procedure of laparoscopic endometrioma excision is pretty much common with other laparoscopic procedure as well. A thin and long telescopic like camera is inserted along with a high intensity light. This instrument is inserted into the naval to evaluate the pelvis of the patient. One or two incision is done on the skin of the abdomen, usually of 5mm length. These incisions are used to access the pelvis and insert the instrument/s. it is through these incisions, that the endometric implants are dissected and removed for further biopsy and medical analysis. There are cases where endometriosis has extensive adhesions and hence, they cannot be resected completely. They are generally deeply involved with uterine wall, ureter or the rectum.
In this kind of scenario and for women who have crossed their childbearing age and have failed to give response to conservative management, the doctor will recommend a hysterectomy for a long term relief procedure.
So if you are planning to undergo a laparoscopic endometrioma excision, you should consult an experienced doctor and get a thorough idea on your condition. Your doctor will suggest you the best procedure according to your condition and the resources available. So get a proper diagnosis and follow your doctor’s advice regarding the same.