For some problems, surgery may be done if medications do not work. Fibroids and cysts can be removed surgically. Endometriosis tissue also can be removed with a special type of laparoscopic surgery. Hysterectomy may be an option.
Laparoscopic (or Robotic-Assisted) Excision of Endometriosis
Laparoscopy, considered the gold standard for diagnosis of endometriosis, is also recognized as subsequent management when conservative therapy fails. Laparoscopic excision or laser ablation of endometriosis is the recommended approach if the patient wishes to preserve her fertility/pregnancy potential.
If pelvic adhesions are severe and involve or invade the bowel and/or bladder, additional concomitant procedures may be required. Sometimes assistance from a urologist or colorectal surgeon is requested.
(Please also see: Robotic-Assisted Resection of Endometriosis under Robotic Surgery )
Laparoscopic (or Robotic-Assisted) Hysterectomy
This option is offered as a last resort for treatment of chronic pelvic pain, or for patients who desire definitive management of pelvic pain due to endometriosis. This may be performed with or without removal of the ovaries and Fallopian tubes.
(Please also see: Robotic-Assisted Hysterectomy under Robotic Surgery )