Surgery Tips

Laparoscopic Excision Surgery to Remove Endometriosis

It is extremely important to find and remove Endometriosis as soon as possible. You may need additional surgeries over the years to combat your Endometriosis. It is important to get the best treatment to minimize unnecessary surgeries.

The best thing you can do is find a qualified Gynecologist that performs excision surgery but even then, the success of the surgery relies entirely on the skill of the surgeon.

Be weary of any doctor that refers to themselves as an Endometriosis Specialist. There are few of them in the entire USA. So unless you have researched extensively and/or traveled a distance, most likely yours is not one of them.

 

Speak with your doctor directly for their preferred process. But some of the standard advice given for laparoscopic excision of Endometriosis are the following:

PRIOR TO SURGERY:

  • Stop taking Ibuprofen, Fish Oil, or any blood thinners 2 weeks prior to surgery.
  • No heavy or hard to digest meals the day before surgery and nothing to eat after 10pm.
  • Many doctors will recommend a bowel prep prior to surgery, especially if it is suspected to affect the bowels.
  • Ask your doctor EXACTLY what procedures they will be performing. You can also find out your surgery ‘procedure codes’ to get an insurance estimate.
  • You will be asked about every medication you take, the strength, and amount. If you don’t know all the info by heart, plan on bringing a medication list, such as the one listed with our Interactive Docs found here.
  • Plan ahead to have someone stay over night the day of your surgery. This is for anesthesia reasons and most doctors will insist on this.

DURING SURGERY:

  • Your surgeon should biopsy the tissue during your laparoscopy to prove it is, in fact, Endometriosis.
  • Many doctors will provide a Stage (1 of 4) based on amount of Endo, size of Endo, and depth of Endo.
  • The biopsy, Stage #, and location of Endo will help in your treatment moving forward.
  • The only way to remove deep Endometriosis lesions is with laproscopic EXCISION surgery. (cutting it out) Simple ablation/cauterization/vaporizing (burning) may only remove Endo from the surface. Although your surgeon can also excise using a laser.
  • Endometriosis can be found anywhere outside of the uterus. Common sites are the cul-de-sacs, and utero-sacral ligaments. Although it is rare, it can be found in other organs such as the lungs, brain, etc.
  • You will wake up with 1 – 4 incision sites depending on the surgeon and location of Endo. Although with advanced cases or difficulty a Laparotomy may be necessary.

POST SURGERY:

  • You will be sore and you may be itchy from the anesthesia.
  • Get your medications before you leave the hospital. Beware of weekend cut-offs. Don’t be afraid to take your pain medication.
  • If you suffer from nausea from the anesthesia or painkillers, ask about an anti-nausea, such as Zofran. Other anti-nausea options include: Phenegran, Dronabinol, or a Scopolamine patch.
  • Ask your doctor if/when it’s okay to take an anti-itch pill or cream, such as Benadryl for the itching.
  • Most hospitals will insist you urinate before they will discharge you and this will most likely hurt or be very difficult to initiate the stream and empty the bladder.
  • You will be groggy for the first day from the anesthesia, which keeps the pain manageable. The 2nd day the pain will be worse. The 4th day the shoulder pain may begin from the gases they use during surgery to inflate your abdomen so they can see inside you.
  • To eliminate the shoulder pain, Lay flat on your back as soon as you get home from the hospital. This will cause the gases to exist faster and travel out your stomach instead of traveling up your entire body and out your shoulders. The shoulder pain hurts and you will be thankful to avoid it. It may also be helpful to put your legs up under a pillow or take anti-gas meds such as Gas-X.
  • Take care of your wounds as they may become infected. Follow discharge instructions when it comes to showering and using products on/near the wounds.
  • You should be expected to take approximately 1-2 weeks off of work after surgery. Take it easy once returning to work, you are still recovering. Although everyone’s bodies recover at different rates, It takes our bodies about 6 weeks to heal from surgery and another 6 weeks to resume to normal. Additionally it may take your whole body a full year to return to what it was before surgery. Allow yourself proper time to heal.
  • Post-op appointments are generally scheduled about 2 weeks from surgery. You should receive your surgical report, photos, and biopsy results during your post-op.

Always call your doctor immediately if you suspect something isn’t right.

 

Don’t forget to treat yourself. This process is a long road. Surgery is scary for a lot of people. For others it is extremely emotional, especially when improving fertility. There are many stresses you can not foresee. Many people who do not understand how difficult this is will let you down. Hopefully this is balanced by those who will be supportive. Regardless of outside factors you may also struggle internally. It’s important to go into surgery with a positive mind. Following surgery treat yourself to the things you can have/do. Eat your favorite foods. Watch your favorite movies. Surround yourself with the people who love you most. Accept that you will have good days, and you will have bad days.

 

Here are additional tips by some of our most trusted resources:

10 Tips for a successful Endometriosis Laparoscopy Recovery – By: Dr. Tamer Seckin

Surgical Risks_Whats the Big Deal_By the Center for Endo Care

Laparoscopy_Beforeandaftertips_ByEllenJohnson_PublishedbyEndometriosis.org

After the Laparoscopy_By the Center for Endo Care

Pain after Surgery_What You Can Expect_By the Center for Endo Care

Post Surgery Ailments_By Ellen Johnson_Published by Endometriosis.org