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Endometriosis Excision

What is Endometriosis?

Endometriosis is a disease in which cells similar to those that line the inside of the uterus (endometrium) grow outside the uterus. The severity of endometriosis can range from mild to severe. It can affect any areas of the abdomen and pelvis, such as the ovaries, uterus, bowel, bladder, liver, diaphragm, and abdominal wall. There are also cases of endometriosis involving areas such as the lungs. In severe cases, extensive scarring and distortion of normal anatomy may occur. Symptoms may include pelvic pain, painful periods, painful intercourse, heavy or irregular periods, infertility, gastrointestinal symptoms including constipation, diarrhea, nausea, bloating, painful bowel movements, urinary symptoms including painful urination and urinary frequency and burning, and general fatigue/malaise. Infertility can also be a concern.

Causes of Endometriosis

The exact cause for the endometriosis is not known. There are several theories but likely the cause is multifactorial. Endometriosis may be inherited genes that run in families.

Diagnosis of Endometriosis

Your gynecologist will ask you about general health and symptoms, as well as perform a pelvic examination. An ultrasound scan or MRI may also be performed.

Excision of Endometriosis

Excision (removal) of endometriosis is a surgery indicated for the treatment of endometriosis where the aim is to preserve fertility.

It can be performed minimally invasively through 2 to 4 tiny incisions using a laparoscope, a slender fiber-optic tube with a camera and light source inserted to provide a clear view of the surgical site, or using the robotic platform. Other surgical instruments are then used to carefully cut and remove the endometriosis lesions, adhesions and ovarian cysts.

Alternatively, the robotic platform is yet another surgical tool that allows a surgeon to operate with 3-D vision, using instruments that can move with more degrees of motion than the surgeon’s wrist. With early stage endometriosis, difficulty identifying disease can often be a concern. Three-dimensional visualization and the ability to magnify tissue up to 10-15 times can, therefore, be very beneficial in identifying endometriosis and removing it accordingly.  In addition, in cases of complex disease, the robotic technique may allow your doctor to operate in areas that may otherwise be difficult to treat.

Other surgical options for excision of endometriosis involve:

Laparotomy: This involves a larger cut in the abdomen which allows the doctor to reach and remove the endometriosis lesions.

Hysterectomy: This is the removal of the entire uterus. This procedure is done when there is severe damage or scarring involving the uterus, the presence of uterine disease, and only if the patient no longer desires future fertility.

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