What is an Endometriosis Excision?

Endometriosis is a common cause of pelvic pain, cramping, and general discomfort in women. The condition occurs when uterine-like cells grow elsewhere in the body, such as the ovaries or rectum. Endometriosis excision is a surgery sometimes indicated to remove the cells, as they can become irritated and inflamed during menstruation and cause a number of uncomfortable symptoms. Many cases of endometriosis can be controlled with medications and hormone replacement therapy, though a severe or persistent problem may require surgery. Endometriosis excision surgery is a highly effective, safe procedure that provides many patients with permanent symptom relief.

Before considering endometriosis excision, a gynecologist will typically attempt to treat the condition with prescription drugs. Birth control pills and other types of estrogen blockers may help to relieve symptoms in many women by suppressing menstruation, which stops endometrial cells from reacting on a monthly basis. Anti-inflammatory drugs and painkillers may also be prescribed. Surgery is considered when conservative treatments fail to provide relief or endometriosis starts to spread to other structures within the pelvis.

Most endometriosis excision surgeries are performed laparoscopically, meaning that surgeons manipulate cameras and small instruments through two or more very small cuts in the abdomen. An incision is typically made underneath the navel so a fiber optic camera tube can be inserted. The surgeon makes another cut in the lower abdomen and uses the camera to guide scissors, scalpels, clamps, and other instruments. A probe may also be inserted through the vagina to move the uterus out of the way during surgery.

After identifying a cluster of endometrial cells on a fallopian tube, ovary, rectal wall, or bladder, the surgeon carefully begins to cut deep into the tissue. With the aid of the camera, he or she digs underneath the entire cluster and separates it from surrounding healthy tissue. The damaged cells and excess blood are removed with a suction device. Following endometriosis excision, the surgeon again inspects the area with the camera and sutures tissue linings to prevent bleeding and infection.

Most excision surgeries can be performed in less than one hour while the patient is under general anesthesia. Following the procedure, the patient is typically brought to a recovery room and monitored by nurses. She can usually leave the hospital in one or two days if complications do not arise. Occasionally, clumps of scar tissue called adhesions can form on organs following surgery that require additional operations.

Some gynecologists prefer a laser ablation procedure to endometriosis excision surgery. Ablation is performed in much the same way except that a laser is used instead of cutting instruments to burn away suspect tissue. The procedure has a lower success rate than excision, however, since it only removes the outermost layers of tissue. Underlying cells can still cause problems in the future. It is important for a woman to discuss surgical options in detail with her gynecologist to understand the risks, benefits, and prognoses associated with each procedure.