Surgical Staging for Endometriosis 

• Severe symptoms: your healthcare provider  may recommend surgical intervention for endometriosis when pain and other symptoms are debilitating and unresponsive to other treatments.
• Infertility: healthcare experts usually recommend surgical intervention in case of infertility, especially in moderate to severe stages. The surgical intervention aims to enhance fertility by removing obstructive lesions and scar tissue.
• Large endometriomas: surgery can be recommended if the ovarian cysts could impact ovarian function or cause pain.
• Organ involvement: surgery may be deemed necessary in cases where bowel, bladder, or other organ involvement causes significant symptoms or complications.
• Failed medical therapy: when hormonal treatments and pain medications do not provide adequate relief, healthcare professionals may consider opting for surgical intervention as a last resort. 
• Suspected malignancy: surgery is considered a feasible option when it is necessary to remove and biopsy lesions that may be malignant.

Why is laparoscopy/robotic surgery better than open surgery for endometriosis?

Laparoscopy and robotic surgery have significantly improved the treatment of endometriosis by offering numerous advantages over traditional open surgery. These minimally invasive techniques provide better outcomes for patients, from reduced pain and faster recovery times to lower complication rates and improved precision. The following table highlights the key benefits of laparoscopy/robotic surgery compared to open surgery.

These advanced techniques of laparoscopic surgery provide better precision and outcomes, which makes them the preferred choice for effective management of endometriosis and fertility preservation.

Is excision or ablation better for endometriosis?

When treating endometriosis, two common surgical techniques are excision and ablation. Both methods aim to remove or destroy endometrial tissue outside the uterus, but they differ in approach and effectiveness. Understanding the differences between excision and ablation can help determine which method may be more beneficial for managing endometriosis symptoms and improving long-term outcomes.

For patients with endometriosis, excision surgery generally offers better long-term outcomes, including more effective pain relief, lower recurrence rates, and improved fertility compared to ablation. While ablation can be effective for superficial lesions, excision is often the preferred choice for comprehensive management of the disease.

Hysterectomy Does Not Treat Endometriosis (Except Adenomyosis)

If you are dealing with endometriosis, you might wonder if a hysterectomy is the solution. However, it’s crucial to know that a hysterectomy, which is the removal of the uterus, doesn’t treat endometriosis unless you only have adenomyosis.

Endometriosis involves tissue growing outside the uterus, affecting areas like the ovaries and pelvic lining. Removing the uterus won’t eliminate this tissue, so symptoms can persist. On the other hand, adenomyosis involves tissue growing within the uterine walls, and a hysterectomy can help in this case by removing the source of pain and heavy bleeding.

For many, managing endometriosis effectively requires a combination of treatments, including excision surgery, hormonal therapy, and pain management. A hysterectomy might be considered if you have severe uterine-related symptoms or adenomyosis, but it’s not a catch-all solution for endometriosis.

Every patient’s experience with endometriosis is different, and a personalised approach that considers the extent of the disease, symptom severity, and overall health is essential for optimal outcomes. Long-term management of endometriosis often requires a comprehensive approach, including lifestyle changes, ongoing medical treatments, and regular follow-ups with your healthcare provider. 

If you suspect that you may be struggling with endometriosis, schedule a consultation to discuss your concerns or symptoms. To learn more about effective long-term strategies and support options, please visit our page on Long-Term Management of Endometriosis.