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Surgery for endometriosis

Surgery can improve your endometriosis symptoms, but it doesn't always get rid of pain. For about 20% of women with endometriosis, surgery doesn't help, even though all the endometriosis has been removed. And about half the women who have surgery will get symptoms again within five years.

Have a full discussion with your specialist doctor so that you completely understand the advantages and disadvantages of each surgery.

Laparoscopy

Laparoscopy, or keyhole surgery, is when a surgeon inserts a small tube, with a camera and instruments attached, into your tummy (abdomen), through your belly button. The aim is to destroy the endometriosis using heat or laser or remove it by cutting (called excising). They'll also remove or destroy any ovarian cysts and divide any adhesions. Adhesions are scar-like tissues inside your body. They grow between surfaces such as organs and the abdominal wall, and make them stick together. Sometimes the surgeon fits a Mirena at the same time as doing a laparoscopy. You can read more about laparoscopy in this leaflet.

Laparotomy

If your endometriosis involves your bowel or bladder, or you have a lot of scarring and adhesions to remove, you need more complex surgery. A laparotomy is open surgery, through a large cut in your tummy (abdomen).

Hysterectomy

If your symptoms badly affect your life and nothing else has worked, doctors may suggest a hysterectomy (removal of your uterus). This would mean you can no longer have children. This can be done with or without removing your ovaries. If your ovaries aren’t removed you may need an operation called an oophorectomy later to remove them. After an oophorectomy, you will go into instant menopause.

You may still have some painful symptoms of endometriosis even after having a hysterectomy.

Written by GP liaison, Christchurch Women's Hospital. Adapted by HealthInfo clinical advisers. Page created September 2021.

Page reference: 900096

Review key: HIEND-30280