Laparoscopic Excision of Endometriosis 

Procedures Offered

Laparoscopic excision of endometriosis

Endometriosis is found in approximately 10% of women and can cause severe pelvic pain and infertility. It is important to diagnose endometriosis early and start management as soon as possible. Hormonal management is often the first line of treatment and may consist of continuous birth control pills, progesterone, hormonal IUD and other options. However, if this fails, surgery is usually the next step. It is imperative to have an experienced surgeon perform the surgery since endometriosis can be subtle and easily missed in early stages and extremely challenging to excise fully in later stages. Generally, the disease starts to develop at the onset of menses and gradually develops from then. The endometriosis lesions usually start at the surface of the lining of the abdomen, but with time they invade deeper into the tissues. If the patient is not adequately diagnosed and treated, endometriosis can start to invade pelvic organs such as the bowel, bladder, ureter and nerves and it may also invade the diaphragm and thoracic cavity. There are two main surgical methods to treat endometriosis, ablation, and excision. Ablation basically means burning the lesion with electrosurgery while excision means cutting away the lesion and removing it. While both may work well for superficial lesions, excision is clearly superior in deeper more fibrotic lesions and it also has the advantage of getting pathologic confirmation of what was treated in the patient. Also, even in superficial lesions, excision is probably better since this method allows the surgeon to remove good margins around visible lesions, thereby reducing the risk of recurrence. Endometriosis can come back, even in the best of hands and the risk of recurrence is associated with age, i.e. it is more common in young patients. The overall risk of recurrence varies, with a recent study showing the risk of reoperation in expert hands being 28% within 10 years. The risk of reoperation is reduced if a hysterectomy is performed, but this is reserved for patients who have completed their childbearing. This reduction of risk may be due to the fact that many patients with endometriosis also have a condition called adenomyosis, which is essentially endometriosis of the uterine wall. Adenomyosis is found in all age groups, but is more common in patients who are in their 30’s and 40’s. Adenomyosis may not be seen during the surgery for endometriosis since it is inside the uterine muscle, but it is generally seen on imaging. Preoperative imaging is very important in patients with suspected endometriosis and adenomyosis and may consist of pelvic ultrasound and MRI.

It is important to set appropriate expectations in patients having surgery for endometriosis and pelvic pain. Pelvic pain may be multifactorial, i.e. not just from endometriosis and therefore not all patients get better after surgery. Many get partially better and some are completely better. In a recent study by Dr. Einarsson, he found that patients that had surgery had on average pain at 9 out of 10 before surgery, but 4 out of 10 after surgery. This means most patients experienced significant symptom relief, but not all of them. Patients also on average missed 3.6 fewer days of work or school after surgery as compared to before surgery. Their quality of life was also significantly improved. In patients who do not fully improve, it is important to continue to seek for reasons and solutions. For example, many women with chronic pelvic pain have pelvic floor dysfunction and it is important to recognize and treat this. Sometimes collaboration with other specialties such as gastroenterology and urology is needed as well.

Video from Laparoscopic excision of endometriosis

Warning: The video on hysterectomy provides a detailed and graphic insight into the surgical procedure, intended for mature audiences due to its explicit content and medical nature.

Important information about the procedure

Laparoscopic excision of endometriosis is a minimally invasive surgical procedure that involves removing endometrial tissue that has grown outside the uterus, typically on the ovaries, fallopian tubes, or other pelvic organs. This procedure is typically performed under general anesthesia and usually takes around 1-3 hours to complete. 

 During the procedure, the surgeon will make several small incisions in the abdomen and insert a laparoscope, which is a thin tube with a camera attached to it. This allows the surgeon to see inside the abdomen and guide the surgical instruments. 

 The surgeon will then use specialized instruments to carefully remove the endometriosis tissue. In some cases, the surgeon may also remove any adhesions or scar tissue that has formed as a result of the endometriosis. 

It is important to discuss the risks and benefits of laparoscopic excision of endometriosis with your surgeon before the procedure and to carefully follow their instructions for post-operative care to minimize the risk of complications. 

Potential complications of laparoscopic excision of endometriosis include:

There is a risk of bleeding during and after the surgery, which may require blood transfusions or additional surgery.

There is a risk of infection at the incision sites or within the abdomen, which may require antibiotics. 

There is a small risk of injury to nearby organs such as the bladder, bowel, or ureter during the surgery, which may require additional surgery to repair. 


There is a risk that the endometriosis may come back after surgery, which may require additional treatment. 

While laparoscopic excision of endometriosis can improve fertility in some women, there is a risk that the surgery may damage the ovaries or fallopian tubes, leading to infertility. 



ome women may experience pain or discomfort after surgery, which may require pain medication or additional treatment.

Laparoscopic excision of endometriosis