Laparoscopy Treatment for Endometriosis

A procedure to look directly at the contents of a patient's abdomen or pelvis, including the fallopian tubes, ovaries, uterus, small bowel, large bowel, appendix, liver, and gallbladder. 

The procedure is usually done in the hospital or outpatient surgical center under general anesthesia (while the patient is unconscious and pain-free). However, very rarely, this procedure may also be done using local anesthesia, which numbs only the area affected by the surgery and allows you to stay awake. 

This surgery is performed by first inflating the abdomen with gas (usually carbon dioxide) through a small incision near the navel (helps to provide a better view inside the abdomen by pushing the abdominal wall and the bowel away from the organs in the pelvic cavity). 

A long thin instrument called a Laparoscope is then carefully inserted into the inflated abdominal cavity to inspect the abdomen and pelvis.

During surgery your body will be tilted slightly with the feet raised higher than the head (allows some of the abdominal organs to shift upward toward the chest and out of the way). 

Endometrial implants can be easily seen once these implants have reached a reasonable size. 

For an accurate diagnosis of Endometriosis, small biopsies should be obtained during laparoscopy. A biopsy (microscopic) is the removal of tiny tissue samples for examination under a microscope that will show that Endometriosis is evident.

Surgeon may go ahead and use further surgical techniques to treat endometrial implants during the first operation that has confirmed the diagnosis of Endometriosis (requires the need for a second small incision in the abdomen so that additional surgical instruments can be inserted). These instruments will be used to surgically treat endometrial implants in a variety of ways.

Surgeon will aim to remove endometrial implants, separate any adhesions, also drain and treat any large cysts.

A laparoscopy becomes a major surgery when treatment is included and your surgeon then uses other instruments to deal with the Endometriosis. This can include cutting or burning away cysts, cutting or burning adhesions, and treating any other complications caused by Endometriosis. 

Things to do/prepare before and after for recovery after surgery:

• Prepare food stocks. Home cook food. Outside food gluten-free only.
• Clean home (Do a day before surgery).
• Change the linen on bed (Do a day before surgery).
• Prepare supply of sanitary towels, pain killers, hot water bottle, some magazines, rent or borrow some videos to entertain.
• Wear loose fitting outfits. Don't wear anything tight, especially round the abdomen.
• Taking extra Vitamin C for about 2 weeks prior to the operation - will help your body deal with the anesthetic as well as help with healing.
• Homeopathic Remedies - Arnica 30c - use this to assist healing and relieve pain after surgery. 
• Phosphorus 6c - to relieve vomiting after anesthetic.
• Throat lozenges - to help with the sore throat caused by the tube which is put down the throat during the operation.
• Place the phone by the bed for easy reach.
• The day before: Eat light and healthy and drink lots of fluids. 
• Do not eat or drink anything for 8 hours before the test. 
• Clean out your bowel. If more severe Endometriosis is suspected, then a full bowel prep may be required. Preparing the bowel with a purging agent such as Magnesium Citrate is often followed by an oral antibiotic and enemas. While unpleasant, this procedure minimizes the risk of surgical complications from bowel injury during surgery.
• Pack a hospital bag including: warm, loose clothing to wear after the operation, wash-kit, phone book - should you need to contact someone, sanitary towels, a blank video - if you are having your procedure taped, something to read if have to wait around for turn in operation theatre, clean socks to keep your feet warm during surgery. Leave your wallet and valuables at home.
• Remove all nail polish, remove jewelery and contact lenses.
• Take a long warm bath the night before, drink some chamomile tea to aid restful sleep, and get a good nights sleep 

After test:

Will feel no pain during the procedure, although the surgical cuts may throb and be slightly painful afterward. Your doctor may prescribe medicine to relieve pain.

With local anesthesia, may feel a prick and a burning sensation when the local anesthetic is given. The laparoscope may cause pressure, but there should be no pain during the procedure. 

May also feel soreness at the site of the surgical cut. A pain reliever may be prescribed by your doctor.

Shoulder pain for a few days, because the gas used during the procedure can irritate the diaphragm, which shares some of the same nerves as the shoulder. 

Have an increased urge to urinate, since the gas can put pressure on the bladder.

Healing will be steady and gradual over the period of about 2 weeks before starting to feel somewhat normal again. 

Going back to work for a least a week, and this is only if a desk job. If any physical work - which most women with Endometriosis cannot anyway - need to consider having at least 3 weeks off work.