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	Laparoscopic Surgery
	uses a thin, telescope-like instrument
	benefits of laparoscopic removal of endometriosis
	Reduced postoperative pain
	Reduced postoperative pain

Fertility Preserving Laparoscopic Surgery

Endometriosis

Endometriosis is one of the most common, benign (non-cancerous) gynecologic conditions. The endometrium is the tissue that lines the uterus. When this tissue grows somewhere else in the body it is called endometriosis. These abnormal growths may cause mild to severe pelvic pain, especially during menstruation. Endometriosis may also be associated with infertility.

Treatment for endometriosis can be either medical or surgical. Various oral and injectable hormones are available to help slow the growth of endometriosis. Although significant improvement results from initial treatment in some patients, others have recurring symptoms and persistent disease. Recent studies demonstrate that endometriosis can be managed equally well with laparoscopic removal. If surgery is the form of treatment your doctor recommends, physicians at the Cleveland Clinic who specialize in this procedure can determine if laparoscopic surgery is appropriate for you.

How is laparoscopic excision of endometriosis performed?

Laparoscopic surgery uses a thin, telescope-like instrument called a laparoscope, which is inserted through a small incision at the umbilicus (belly button). The laparoscope is connected to a tiny video camera – smaller than a dime – which projects a view of the operative site onto video monitors located in the operating room. The abdomen is inflated with carbon dioxide, a gas, to allow your surgeon a better view of the operative area. Two or three additional small incisions are made near the laparoscope through which the surgeon inserts specialized surgical instruments. The surgeon uses these instruments to remove the endometriosis and scarred tissue around it, while preserving the uterus, tubes, and ovaries. If endometriosis involves the bowel, it can be removed at the same time. Following the procedure, the small incisions are closed with sutures and covered with surgical tape. After a few months, they are barely visible.

What are the benefits of laparoscopic removal of endometriosis?

	Three or four tiny scars instead of one large abdominal scar
	Shorter hospital stay – you may leave the same day or the day after surgery
	Reduced postoperative pain
	Shorter recovery time – days instead of weeks – and quicker return to daily activities, including work
	Avoidance of the side effects often experienced with hormone therapy
	Preservation of ovarian function
	Preservation of fertility

What can I expect after surgery?

It is important to follow your doctor’s instructions after surgery. Although many people feel better in just a few days, you may need to take it easy for two to four weeks.

Pelvic Adhesion & Fallopian Tube Related Surgery

Pelvic adhesions (scar tissue) and blocked or damaged fallopian tubes are another common cause of infertility. Adhesions can result from infection, previous surgery or endometriosis. There are several treatment options, including laparoscopic surgery, open microsurgery, or in vitro fertilization-embryo transfer (IVF-ET). Once the fallopian tubes have been damaged, they function poorly, even after surgical repair. For many women, the best option for fertility is IVF-ET, which bypasses pelvic adhesions and blocked tubes. When pelvic pain is the problem, surgery may be more helpful.

Surgery for Fibroids

"Fibroid" is the common name given to benign smooth muscle tumors of the uterus. Fibroids may be single or multiple, small or large, and in various locations inside or outside the uterus. They may cause pain or abnormal uterine bleeding. When fibroids grow inside of the uterus, they may cause repeated miscarriages or infertility. For women who have completed their families, hysterectomy may be the best treatment. For women who want to conceive, removal of the fibroids may be possible. This procedure is called myomectomy. Drugs such as Lupron Depot can temporarily shrink fibroids, making myomectomy easier. When fibroids grow inside the uterus (submucous fibroids), they can be removed by hysteroscopy.