Laparoscopic Endometriosis Surgery
What is Laparoscopic Endometriosis Surgery ?
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Why do you need Laparoscopic Endometriosis Surgery ?
Laparoscopic endometriosis surgery is indicated for:
- Diagnosis:
- Suspected endometriosis: Chronic pelvic pain, painful periods (dysmenorrhea), pain during intercourse (dyspareunia), or infertility.
- Inconclusive imaging: Ultrasound/MRI may not confirm endometriosis; laparoscopy is the gold standard for diagnosis.
- Treatment:
- Pain relief: Excision or ablation of endometriotic implants to reduce pain.
- Infertility: Removal of lesions/adhesions to improve fertility (e.g., in stage I–II endometriosis).
- Endometriomas (ovarian cysts): Drainage and excision of cyst walls.
- Severe endometriosis (stage III–IV): Removal of deep infiltrating endometriosis (DIE) affecting organs like the bowel or bladder.
- Recurrence or failed medical treatment:
- Persistent symptoms despite hormonal therapy (e.g., oral contraceptives, GnRH agonists).
The procedure aims to confirm the diagnosis, remove endometriotic tissue, relieve pain, and improve fertility while preserving reproductive organs when possible.
Why Do Laparoscopic Endometriosis Surgery Costs Vary in Philippines?
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Laparoscopic Endometriosis Surgery Procedure
- Before Surgery Evaluation:
- Diagnosis:
- Transvaginal ultrasound: Detects endometriomas or signs of deep endometriosis.
- MRI (if needed): Maps deep infiltrating endometriosis (DIE) involving bowel/bladder.
- Blood tests: CA-125 (elevated in endometriosis, but non-specific); hemoglobin, clotting profile.
- Hormonal therapy: Often stopped 4–6 weeks prior to avoid masking lesions.
- Medications: Bowel prep (if bowel involvement); antibiotics (e.g., cefazolin) pre-surgery.
- Consent: Risks, including organ injury, are explained.
- Diagnosis:
- Surgical Techniques:
- Diagnostic Laparoscopy:
- Performed under general anesthesia, lasting 30–60 minutes.
- A small incision (0.5–1 cm) is made near the navel; a laparoscope (camera) is inserted.
- CO2 gas inflates the abdomen for better visualization.
- Additional 1–2 small incisions (0.5 cm) may be made for instruments to inspect the pelvis.
- Endometriosis is identified (e.g., implants, adhesions, endometriomas); staging (I–IV) is done per the American Society for Reproductive Medicine (ASRM) classification.
- Operative Laparoscopy:
- Lasts 1–4 hours, depending on severity (e.g., DIE, adhesions).
- Excision: Endometriotic implants are cut out using laparoscopic scissors or laser (preferred for long-term pain relief).
- Ablation: Lesions are burned with heat or laser (less effective for deep lesions; higher recurrence).
- Endometrioma treatment: Cyst wall excised (cystectomy) to preserve ovarian tissue; drainage alone has a higher recurrence rate.
- Adhesiolysis: Adhesions (scar tissue) are removed to restore anatomy and improve fertility.
- Deep infiltrating endometriosis (DIE): May involve bowel resection, bladder repair, or ureterolysis (freeing ureters), requiring a multidisciplinary team (e.g., colorectal surgeon).
- Intraoperative Tools:
- Laparoscope: Visualizes pelvic structures.
- Endometriosis-specific probes: Identify subtle lesions.
- Ultrasound (if needed): Guides deep lesion excision.
- Diagnostic Laparoscopy:
- After Surgery:
- Hospital stay: 1–2 days (diagnostic or mild cases); 2–4 days (severe cases, e.g., DIE).
- Pain management: IV analgesics (e.g., morphine) for 1–2 days, then oral (e.g., ibuprofen).
- Antibiotics: For 1–3 days to prevent infection.
- Pathology report: Within 5–7 days (confirms endometriosis if tissue excised).
- Hormonal therapy: Often restarted (e.g., GnRH agonists, progestins) to suppress recurrence, unless attempting pregnancy.
Recovery After Laparoscopic Endometriosis Surgery
- Hospital Stay: 1–2 days (mild cases); 2–4 days (severe cases).
- Post-Surgery Care:
- Pain: Incision pain and shoulder discomfort (from CO2 gas) for 3–5 days, managed with analgesics.
- Activity: Walking within 24 hours to prevent clots; avoid heavy lifting (>5 kg) or strenuous activity for 4–6 weeks.
- Bleeding: Light vaginal spotting for 1–2 weeks; heavy bleeding is abnormal.
- Bowel/bladder: Normal function resumes in 1–3 days; laxatives if constipated (esp. bowel surgery).
- Intercourse: Avoid for 4–6 weeks until healed.
- Hormonal therapy: Resumed (if not trying to conceive) to reduce recurrence.
- Diet: Start with liquids, progress to solids; high-protein foods (e.g., eggs, lentils) and fiber (e.g., fruits) aid healing; 2–3 liters water daily.
- Follow-Up:
- Visit at 1–2 weeks for wound check; 6 weeks for recovery assessment.
- Ultrasound/MRI (if DIE): At 3–6 months to monitor recurrence.
- Fertility follow-up: Attempt conception within 6–12 months (if desired), as fertility benefits are time-limited.
Most resume normal activities in 2–4 weeks (mild cases) or 4–6 weeks (severe cases). Pain relief: 70–85% experience significant improvement; fertility improvement: 30–50% conceive within 1–2 years (stage I–II).
Risks and Complications
- Surgical Risks:
- Bleeding (2–5%): 1–2% may need transfusion; rare reoperation.
- Infection (1–3%): Wound or pelvic; treated with antibiotics.
- Blood clots (1–2%): Deep vein thrombosis (DVT); early ambulation reduces risk.
- Organ Injury:
- Bowel/bladder injury (1–2%): More common in DIE; may need repair (e.g., bowel resection).
- Ureter injury (<1%): Requires stenting or repair.
- Long-Term:
- Recurrence (20–40% within 5 years): Higher with ablation vs. excision; hormonal therapy reduces risk.
- Adhesions (5–10%): Scar tissue causing pain or infertility; may need repeat surgery.
- Ovarian reserve reduction (5–10%): After endometrioma surgery; risk of premature ovarian failure if extensive.
- Chronic pain (5–10%): If nerve involvement or incomplete lesion removal.
- Fertility: Improves in 30–50% (stage I–II); less effective in stage III–IV or with ovarian damage.
Report fever, severe pain, heavy bleeding, or difficulty urinating/bowel movements promptly.
Frequently Asked Questions (FAQs)
What causes endometriosis?
Exact cause unknown; theories include retrograde menstruation, genetic factors, immune dysfunction, or environmental triggers.
Can I avoid surgery for endometriosis?
Yes, for mild symptoms: 50–70% improve with medical treatment (e.g., hormonal therapy); surgery is for severe pain, infertility, or failed medical management.
Is laparoscopic surgery painful?
Not during surgery (general anesthesia); post-surgery pain (incisions, gas) for 3–5 days, managed with medication.
How soon can I resume activities?
Light activities in 1–2 weeks; normal routines in 2–6 weeks, depending on surgery extent.
Is laparoscopic endometriosis surgery covered by insurance in India?
Yes, for symptomatic cases; confirm with your provider.
Signs of complications?
Fever, severe pain, heavy bleeding, or difficulty with urination/bowel movements.
Will endometriosis recur after surgery?
20–40% risk within 5 years; excision and post-op hormonal therapy reduce recurrence.
Lifestyle changes post-surgery?
Avoid heavy lifting for 4–6 weeks, consider hormonal therapy to suppress recurrence, attend follow-ups, and pursue fertility treatment (if desired) within 6–12 months.
Conclusion
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Looking for Best Hospitals for Laparoscopic Endometriosis Surgery
Note: we are not promoting any hospitals
We do not promote any hospitals. All details are sourced from Google and hospital websites. Please verify independently. Start with your surgery—here’s the list of government, budget, and superspecialty hospitals accredited by the Department of Health (DOH), Philippine Health Insurance Corporation (PhilHealth), and Joint Commission International (JCI)
- click on your city and schedule your surgery now done in good hands.
| City | Minimum Price (₱) | Maximum Price (₱) |
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Angeles City |
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Antipolo |
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Bacolod |
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Bacoor |
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Baguio |
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Butuan |
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Cagayan de Oro |
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Caloocan |
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Cebu City |
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Dasmariñas |
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Davao City |
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General Santos |
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General Trias |
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Iligan |
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Iloilo City |
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Las Piñas |
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Makati |
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Malolos |
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Manila |
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Muntinlupa |
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Parañaque |
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Pasay |
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Pasig |
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Puerto Princesa |
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Quezon City |
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San Fernando |
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San Jose del Monte |
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Taguig |
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Valenzuela |
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Zamboanga City |
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Disclaimer
This information is sourced from open platforms and is for general awareness only. Costs may vary based on individual cases. Please consult a qualified doctor for medical advice and explore options within your budget before deciding on the procedure.