Laparoscopy for the Evaluation and Treatment of Endometriosis

What is endometriosis?

Endometriosis occurs when tissue from the inner lining of the uterus (called the endometrium) spreads outside of the uterus. This tissue continues to act just as it would inside the uterus during the menstrual cycle — thickening, breaking down and sometimes bleeding. The causes inflammation and irritation, resulting in pain, especially during a girl’s period.

There is no cure for endometriosis, but treatment can help young women manage their symptoms and significantly reduce pain. Because endometriosis spreads over time, it’s best to evaluate and treat as soon as possible to minimize long-term pain.

Using diagnostic laparoscopy for endometriosis

The only way to diagnose the condition is to perform a procedure called a diagnostic laparoscopy. This minimally invasive surgical procedure allows your daughter’s doctor to look at the pelvic organs with a small camera.

We may order a pelvic ultrasound or magnetic resonance imaging (MRI) test prior to the procedure to rule out other possible conditions. An ultrasound uses soundwaves to produce an image of inside the pelvis, while am MRI uses magnets to produce the image.

Why choose us for diagnostic laparoscopy and laparoscopic surgery for endometriosis?

At Children’s Hospital Colorado, our board-certified pediatric and adolescent gynecologists have specialized training and a wealth of experience in the reproductive issues of girls and women of all ages.

We understand that endometriosis can be stressful, and we are sensitive to your daughter’s needs. We work to put families at ease by carefully explaining the condition, discussing the various treatment options for endometriosis and supporting your family after surgery. That includes follow-up visits and consultation with our colleagues in other specialties as needed, including psychology, chronic pain, urology and gastroenterology.

We provide the highest standard of surgical care, routinely performing laparoscopy on adolescent patients. Our anesthesiology team is specifically trained in the airway management of children and teens, carefully monitoring breathing during the procedure and ensuring airway passages are clear. Our team also recognizes that this surgery can be a scary process for a young woman and takes extra steps to be gentle and sensitive in their care.

What to expect during laparoscopy for endometriosis

Outpatient laparoscopic surgery for endometriosis can effectively diagnose and treat the condition during the same operation. While there are both non-surgical and surgical treatment options for endometriosis, laparoscopic surgery is often the best option for many girls and young women.

During the procedure, your daughter will be under general anesthesia, which keeps her asleep during surgery. She won’t feel any pain or remember the procedure.

The surgeon then makes two or three very small incisions, about 5mm in length, on your daughter’s abdomen. One incision is used to place a camera, and the other incisions are used to insert surgical instruments.

The surgeon uses the camera with a light system to see inside the abdomen and pelvis. They fill the surgical area with safe carbon dioxide (CO₂) gas to expand it, which provides a better view and more room to maneuver.

The surgeon then uses the surgical instruments to explore the pelvis, looking for the cause of pelvic pain, as well as potential deposits of endometriosis. They carefully cut or burn away the endometriosis lesions using a combination of a CO₂ laser and high-energy electrosurgery devices.

After the procedure, the surgeon closes the incision sites with absorbable sutures under the skin. The stitches will dissolve on their own and don’t need to be removed later.

The surgery takes approximately 1 to 2 hours, depending on the size and number of the endometriosis lesions.

What to expect after laparoscopy for endometriosis

Your daughter will be able to go home 1 to 2 hours after surgery. Like any other procedure performed under anesthesia, she may experience nausea and vomiting. These side effects are related to the anesthesia medicines and the surgeon’s movement inside the abdomen during the procedure.

A unique side effect caused by laparoscopic surgery is shoulder pain, which may last for 2 to 3 days following surgery. This is caused by the carbon dioxide gas used during surgery. Your daughter may also experience pain at the incision sites, but this tends to be mild, given the small size of the incisions.

Recovery varies from one patient to the next, but in general, girls can return to most regular activities within a few days to one week. Your daughter should not shower for 24 hours after surgery and should not swim or take a bath for one week after surgery.

In addition to routine post-surgery care, we’ll schedule follow-up appointments to discuss all findings from the surgery. We can also talk about hormonal treatments to help manage your daughter’s pain long-term and minimize the recurrence of new endometriosis lesions.

If you have any questions or concerns after the procedure, call the ParentSmart Healthline at 1-855-KID-INFO (543-4636). Caring pediatric nurses are available 24 hours a day, 7 days a week to help answer your questions.