Recovery for Endometriosis Surgery

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Management of endometriosis is highly personal

Recovery for endometriosis surgery seems like a last resort thing to worry about. But the discomfort caused by endometriosis can have a significant negative effect on your quality of life. This can be particularly aggravating if pain meds do not appear to be helping. Also, really? Pain meds are not the way to treat endo. You need the real deal combined surgical and integrative medical approach, which bring together both mainstream and natural methods.

For most women with endometriosis, surgical treatment might be the main alternative at some point. But it can be tough to understand what to expect from a surgical procedure– and also whether or not it’s the appropriate decision for you.

Listed below are some responses to inquiries you might have regarding surgical procedures for endometriosis.

Why is endometriosis surgical treatment even considered?
Surgery seems radical and invasive but can be the best thing you ever did.  Endometriosis triggers cells that generally exist on the inside cellular lining of your womb (endometrium) to somehow implant and grow in other parts of your abdomen.

This misplaced cell growth can create symptoms like MAJOR discomfort that can occur during your period, intercourse, or defecation, or peeing or at random. Having endometriosis can additionally make it harder for you to get pregnant.  So, often fertility is the reason it comes to a head and attention. 

When it comes to treating your endometriosis, your physician could recommend surgery if:

You have extreme pain: Due to the fact that the endometrium is growing where it does not belong, endometriosis can influence surrounding cells, resulting in pain and also swelling. Sometimes pain can be severe and substantially interfere with your day-to-day activities.
Medications haven’t helped: Hormonal agent treatment and discomfort medications can commonly help to alleviate symptoms in some phases of endometriosis. Some stages of endometriosis don’t react well to medicines. It’s tough to manage without surgery. 

You’ve been trying to get pregnant: Endometriosis can cause damage to eggs. But mainly, in severe cases, scar tissue from endometriosis can block the fallopian tubes. This can make it harder for a person with endometriosis to be fertile because the system is blocked.

Surgical treatment and fertility:
According to the American College of Obstetricians and also Gynecologists (ACOG), roughly 40 percent of individuals with inability to conceive are suffering from endometriosis.

Having surgical treatment is a big decision– especially if you’re considering a hysterectomy, which removes your uterus and potentially your ovaries. Without ovaries and a womb, you can not get pregnant.  But this type of surgery is of last resort anyway. 

What types of surgery are utilized to deal with endometriosis?
Endo treatment makes use of 2 primary treatments for endometriosis: medication and surgery. Your physician may first try to treat your endometriosis with drugs.  But there is a big problem with that.  The only way to make a diagnosis at this time is surgery and biopsies.  So, without that, you don’t know what you’re treating.  Still, some docs still treat based in symptoms and scans and a presumed diagnosis of endometriosis.  Bad idea in general. 

For painful but low level discomfort, painkillers like ibuprofen (Advil, Motrin) or naproxen (Aleve) may be enough to control signs and symptoms of discomfort, but will not reduce the development endometriosis growth.  It is ONLY helping with symptoms of pain….maybe. 

For others, birth control pills or gonadotropin-releasing hormonal agent agonists (GnRH) can stop endometriosis cells from expanding outside the uterus in some cases but with the major side effect of menopausal hot flashes. There are other meds related to this which do not produce these symptoms as much (agonists vs antagonists).  But the problem is that endometriosis is not simply endometrial cells that are growing outside the uterus. They are different in molecular behavior inside.  So, radical medical therapy is not ideal because it provides some benefit and a lot of potential harm and side effects. 

Surgical treatment usually isn’t offered as an initial action, unless symptoms warrant it.  But is should be, at least to make a diagnosis if not as part of treatment. When surgical treatment is advised, physicians do three main sorts of surgical treatment to deal with endometriosis. We’ll take a look at each of these in even more detail listed below.

Prior to your surgical procedure, your doctor will offer you particular guidelines regarding when to quit consuming vitamins and herbs that might make you bleed easier. You might likewise need to stop taking some sorts of medication.

Be sure to follow your physician’s guidelines meticulously to ensure that your treatment can continue for the best possible outcome. 

Laparoscopy surgical procedure for endometriosis.
Laparoscopy is a kind of minimally-invasive surgical procedure. It uses a tiny, slim cam called a laparoscope and just requires little cuts to see right into the abdominal area.

Laparoscopy is performed under general inhalational anesthesia. That means that you’ll be asleep and won’t feel anything. 

Throughout laparoscopy, this is what happens: 

Your belly will be inflated with carbon dioxide gas to assist the surgeon to see inside your abdomen. It just creates some space.  The surgeon makes a few little cuts near or in your  belly button. They’ll place a lighted laparoscope right into one of these. Surgical tools will be put into the various other openings or ports.

The endo excision surgeon will use sharp scissors, sometimes cautery or a laser to remove as much of the endometriosis tissue as possible from body organs like your ovaries, bladder, fallopian tubes, as well as near or on the rectum. Part of this tissue might go to a pathology laboratory for testing and to ensure the diagnosis.  The best approach is something called “excision” or removal, rather than “fulguration” or burning away.  This is less traumatic to your body and reduces the risks of injuring anything while helping to remove the abnormal endometriosis tissue as best as possible. 

Lastly, the doctor will close the incisions with tiny sutures or glue.
You ought to have the ability to go home on the very same day as your surgical treatment.

Robotic surgery for endometriosis excision

This is almost the same as laparoscopy except a million times better.  There are some that argue this point but there are reasons why robotics is “better”.  The optics are 3D so the surgeon can see very tiny imperfections and can tell how deep they are relative to delicate organs like the ureter, bladder and bowel.  This means less injury risk. 

The instruments are wristed and move likely tiny human hands as opposed to straight scissors and graspers, which make this surgery skin to eating with sloppy erratic chopsticks.  It is a much more delicate way to operate, creates less trauma and your body thanks you for it.  

Laparotomy surgical treatment for endometriosis
Laparotomy is additionally called an open surgical procedure. This is done through large incisions and was the standard way of performing many surgeries.  But this is yesterday in most cases.  

As with laparoscopy, laparotomy is done under a general anesthetic, indicating that you’ll be sleeping as well as will not really feel discomfort throughout your surgical treatment.

Making use of a laparotomy for endometriosis is rare these days. It’s possible that it may be utilized when endometriosis is substantial or your physician needs to get rid of patches of endometriosis that can not be seen well using laparoscopy.  Generally speaking, this means you are not in the hands of an expert minimally invasive surgeon and should probably look elsewhere.  Never say never, but open laparotomy is almost a “never necessary” event these days.  The recovery is WAY more painful and you spend more days in the hospital and many more weeks recovering.  

Hysterectomy for endometriosis
Hysterectomy is a procedure that can be used to deal with a lot more severe endometriosis when preserving fertility isn’t something that is desired. 

Unlike conservative surgery, the doctor will certainly remove your uterus, and possibly your cervix, ovaries (oophorectomy), and fallopian tubes (salpingectomy).  Obviously this means you can no longer become pregnant. 

It is very important to review your surgical alternatives very carefully with your medical professional before determining to have a hysterectomy.  Often it is not necessary but, for example, if you have something called adenomyosis and do not want to have kids at this point you will get the best pain relief with a hysterectomy.  Excising just the endo around the uterus is simply not enough.

Hysterectomy surgical procedure can be done via a couple of different methods:

Laparoscopic or robotic: In this minimally-invasive surgery, the endometriosis surgeon makes a few small incisions in your abdomen as noted above. Your uterus and also possibly your cervix and also ovaries are removed vaginally in most cases. This treatment can occasionally make use of robot surgical treatment, aided by computer-assisted innovations.  Again, this is the best way to go regardless of what others may say. They are deluded. 

By laparotomy: Additionally called an abdominal hysterectomy, using this approach the surgeon makes an incision in your abdomen (bikini cut transverse or vertical) and removes the uterus and/or tubes and ovaries this way.  Hugely unnecessary in most cases. 

Vaginally: The uterus CAN be removed vaginally without abdominal incisions of any kind in many situations.  But this is usually for other conditions and not endo.  For endo surgery the surgeon needs to look around in the pelvis and abdomen to remove endometriosis and this is not possible when looking up the vaginal canal only.  There is simply no way to see well. 

BEST BET ENDOMETRIOSIS SURGERY RECOVERY:

Find an expert robotically capable endometriosis excision surgeon. You will not regret it. But keep in mind there is more to this than just the surgery. The surgeon needs to get you through the pre-op and post-op phases, and this is best handled when the surgeon is knowledgable about integrative recovery techniques. Finally, there are many ways to make sure the surgery will give you lasting results and this also requires an expert or a team of experts that can help you defeat endo and get your life back.

Discover more about the BEST way to get endometriosis excision surgery and all the pros and cons.

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“I help and guide women to beat endometriosis and gynecologic cancers that are associated with endo, like ovarian cancer, using a unique combination of minimally invasive robotic surgery, precision medicine therapies and complementary holistic natural support towards thriving in survivorship." Dr. Vasilev is the only physician triple board certified in Ob-Gyn, Gynecologic Oncology and Integrative & Holistic Medicine in the United States. He is an accomplished advanced robotic master surgeon, and is internationally vetted by iCareBetter (https://icarebetter.com/doctor/dr-steven-vasilev/). He serves as Professor at the world-renowned Saint John's Cancer Institute in Santa Monica, California and is Clinical Professor at Loma Linda University School of Medicine. He is former faculty and professor at UC Irvine, UCLA, USC and City of Hope and was the founding Medical Director of Integrative Medicine at Providence Saint John's Health Center. He is an active member of multiple medical societies and has been nationally listed in "Best Doctors" for over 20 years.