Tamer Seckin, M.D.
Co-Founder, Endometriosis Foundation of America
Laparoscopic excision surgery is considered the “gold standard” of endometriosis surgeries because it excises without leaving any diseased tissue behind. When pain medication and hormonal therapy are not providing sufficient relief for patients, surgery becomes a serious option.
A thorough solution
Laparoscopic excision surgery doesn’t zap out the tip of the disease, as laser surgery does. Instead, it removes the inflammatory tissue down to its roots. Think of an iceberg. Shaving off the top of the iceberg down to water level would appear to leave behind a clean and smooth surface, but we know the most extensive and dense part of the iceberg remains below the water. That “shaving” would be analogous to endometriosis surgical techniques that use laser ablation, electrical fulguration or other procedures involving electrical current that zap the part of the endometriosis above the organ’s surface. The portion below is still there, left to grow and flourish. Laparoscopic excision surgery permanently removes the entire iceberg, or endometriosis nodule, providing the most pain relief.
Step by step
The surgery begins when a needle is inserted into a small incision made through the navel. For better visualization inside the abdominal cavity, carbon dioxide is injected. This colorless, odorless gas swells the cavity, lifting and separating the organs so the laparoscope can be safely inserted. Similar incisions will likely be made in the pubic hairline and/or over the ovaries, through which surgical instruments can be inserted. Once all the instruments have been strategically inserted, the surgeon can identify the suspected endometriosis lesions, excise them and obtain tissue samples for a pathological examination. One of the most critical aspects of the excision surgery and the only way to diagnose endometriosis is with confirmation by a pathologist, who views a tissue sample under a microscope.
Doctors cannot promise a patient that her pain will be reduced to a specific level; no doctor can guarantee a precise result with any treatment. But laparoscopic excision surgery is a procedure with a high rate of success, and it is the most thorough form of treatment that provides significant pain relief.