Endometriosis laparoscopy

Endometriosis disease, which is characterized by the growth of tissue similar to the inner lining of the uterus (endometrium) outside the uterine cavity, is one of the most complex and painful health problems among women of reproductive age. This disease, which is also known as the "silent disease", can cause a wide range of symptoms, from chronic pelvic pain and severe menstrual pain to infertility, and can severely affect a person's quality of life.

Despite significant advances in non-invasive diagnostic methods such as ultrasound and MRI, often the only definitive way to definitively diagnose and effectively treat endometriosis lesions is to use surgical techniques. In the meantime, laparoscopic surgery, as a minimally invasive method, has created a revolution in the management of this disease and is known as the gold standard for endometriosis diagnosis and treatment.

We are going to discuss how this delicate surgery allows surgeons to identify, evaluate, and destroy abnormal tissues with minimal incisions and preserve maximum fertility, so that the patient can return to a normal life as quickly as possible without pain. href="#%D8%A2%D9%86%D8%AF%D9%88%D9%85%D8%AA%D8%B1%DB%8C%D9%88%D8%B2-%DA %86%DB%8C%D8%B3%D8%AA-%D9%88-%DA%86%D9%87-%D8%B2%D9%85%D8%A7%D9%86%DB%8C -%D9%86%DB%8C%D8%A7%D8%B2-%D8%A8%D9%87-%D8%AC%D8%B1%D8%A7%D8%AD%DB%8C-%D Endometriosis What is it and when does it require surgery?

role Laparoscopy in the treatment of deep endometriosis and endometrioma

era Recovery and care after laparoscopic surgery

role The skill of the surgeon in the success of laparoscopic endometriosis surgery

conclusion

What is endometriosis and when does it need surgery?

Endometriosis is a chronic disease in which tissue similar to the inner layer of the uterus (endometrium) grows outside the uterus, mainly in the pelvis, ovaries and peritoneum. This misplaced tissue is affected by monthly hormonal cycles and bleeds just like the endometrium. Since this blood has no way to leave the body, it causes inflammation, pain, formation of adhesions and scar tissue.

This disease has different degrees from mild to severe. In the early or mild stages, drug treatments such as pain relievers and hormone therapy are usually prescribed to control pain and prevent disease progression. However, when the pain becomes chronic and unbearable or when the patient is facing infertility problems due to the presence of endometriosis, more detailed interventions are needed.

The need for surgery is often suggested when clinical symptoms do not respond to medical treatments, or in cases where

key advantages of endometriosis laparoscopy compared to open surgery

endometriosis laparoscopy has significant advantages over traditional open surgery methods due to its minimally invasive nature, which has made it the gold standard for the treatment of this disease. Open surgery requires a large incision in the abdomen so that the surgeon can directly access the internal organs, while laparoscopy uses several small incisions (usually less than one centimeter).

This reduction in the size of the incisions directly affects the patient experience. The most important advantage is less pain after the operation, because there is less invasion of muscle and skin tissues. Reduced pain means less need for strong painkillers and easier management of the recovery period.

In addition, the recovery and return to daily activities time in endometriosis laparoscopy is significantly shorter. In open surgery, the patient may require weeks of absolute rest, while in laparoscopy, many patients can return to light activities within days.

Also, the reduced size of the incisions means reduced risk of infection and reduced post-surgical adhesions. Adhesions are one of the common side effects of abdominal surgery, which can lead to chronic pain. While laparoscopy minimizes this risk by causing minimal damage.

Steps of performing endometriosis laparoscopy for diagnosis and treatment

Endometriosis laparoscopy surgery is a precise and multi-step process. It is a procedure that is often performed under general anesthesia. The first step is to create access. The surgeon makes a very small incision (usually near the navel) and inserts a special needle into the abdomen to inject carbon dioxide gas.

The carbon dioxide gas inflates the abdominal cavity and separates it from the abdominal wall. This allows the surgeon to see the internal organs more clearly and insert instruments without damaging the viscera. In the second stage, the laparoscope (a narrow tube with a camera and a light source at the tip) is inserted through the same umbilical incision.

Laparoscope magnified images of the pelvic cavity on The monitor displays. During this step, the surgeon makes other small incisions needed to insert the delicate surgical instruments. This step is the most critical part of diagnosis; Because the surgeon can directly observe all endometriosis lesions, adhesions and cysts and accurately assess the severity of the disease. Finally, the treatment phase begins. Using special tools and techniques such as burning (coagulation) with laser or electrical energy, the surgeon separates and removes endometriosis lesions from healthy tissues. If there are ovarian cysts (endometrioma), the surgeon carefully drains them and removes the cyst capsule. After ensuring the complete removal of the lesions, the gas is evacuated and the incisions are closed with fine sutures.

The role of laparoscopy in the treatment of deep endometriosis and endometrioma

Endometriosis can penetrate at different levels of the pelvic cavity; Superficial lesions that are easily visible and deep endometriosis that has penetrated more than 5 mm into tissues, such as the bladder, bowel, or uterine ligaments. Endometriosis laparoscopy has a vital function in dealing with these complex lesions, due to the possibility of image magnification.

The high magnification of the laparoscope image allows the surgeon to see the border of the deep endometriosis lesion much more accurately than open surgery. This is especially important when removing lesions that are close to vital organs and minimizes the risk of injury to them (such as the ureters, bowel, or pelvic nerves). style="border-width:15px">

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In the case of endometrioma (chocolate ovarian cysts), endometriosis laparoscopy is the preferred method. With delicate surgical techniques, the surgeon can carefully separate the cyst from the ovarian tissue and remove its capsule completely. The goal here is to completely remove the cyst and at the same time preserve the maximum amount of healthy ovarian tissue, which is necessary to preserve the ovarian reserve and future fertility of the patient. In general, for the successful treatment of deep endometriosis and endometrioma, a complex surgery is required and skills that only surgeons specializing in advanced laparoscopy of endometriosis have. This method, by providing a clear and precise view, enables the complete excision (removal) of lesions with the least side damage.

Effect of endometriosis laparoscopy on improving the chance of pregnancy

One of the main motivations to perform laparoscopy Endometriosisin women trying to conceive, increasing the chance of a natural pregnancy or success in assisted reproduction methods (such as IVF). Endometriosis can cause infertility through various mechanisms, such as creating chronic inflammation in the pelvis, creating adhesions that disrupt the path of the fallopian tubes and ovaries, and negatively affecting the quality of eggs and embryos. Laparoscopic endometriosis surgery can eliminate these physical and chemical obstacles by removing endometriosis foci and lesions. The removal of adhesions allows the fallopian tubes to properly direct the egg released from the ovary to the uterus and the normal function of the pelvic organs returns.

Removing endometrioma cysts also, despite the possible risks of reducing the ovarian reserve if the surgeon is not skilled, usually reduces chronic inflammation in the ovary and provides a better hormonal environment. Studies have shown that after successful laparoscopic surgery, the chance of pregnancy in women with mild to moderate endometriosis increases significantly.

However, it should be noted that endometriosis laparoscopy is not a definitive cure for infertility, but rather a contributing factor. The success rate depends on the severity of the disease, the age of the patient and the skill of the surgeon. In any case, for patients whose infertility is caused by the mechanical and inflammatory factors of endometriosis, this surgery can be the key to return to the fertility path. Laparoscopy for endometriosis has a shorter recovery period than open surgery, but this does not mean that care is not needed. Immediately after surgery, the patient may experience mild to moderate pain in the area of the incisions as well as pain in the shoulder, which is caused by the carbon dioxide gas injected into the abdomen. The incision area should be kept clean and dry, and signs of infection such as redness, swelling, or abnormal discharge should be reported to the doctor immediately.