As the name suggests, the Conservative Surgery is performed in such a fashion that your uterus and ovaries are kept intact and Endometrial Cells are removed. This is done to preserve your chances of getting pregnant. Many women suffering Endometriosis have benefited with this procedure and achieved pregnancy, who were suffering unbearable pain cramps. But, as you already know by now, endometriosis has no permanent cure. The endometrial tissue may develop again and the severe pain may return to you.
There is no denying the fact that all surgical treatments provide significant relief, but, sometimes, they are too harsh and irreversible. Since you know that Endometriosis may attack you again and the pain and other symptoms may make a comeback, it is advisable to discuss the details of your suffering with your treating doctors. It is pertinent to know what kind of surgery you are opting for. Will your ability to get pregnant remain unharmed?
There are a number of surgical procedures that can remove Endometriosis, but our focus, as of now is on Conservative Surgery.
In Laparoscopy, the treating doctor uses a device called Laparoscope that is inserted into the abdomen to examine the growth of endometrial tissue. The insertion is done by making a small cut in the abdomen.
Once the Endometriosis growth is identified, the doctor may make two extra tiny cuts in the abdomen to facilitate lasers or any other surgical device insertion. That is done to perform Endometriosis excising process. The endometrial tissues are removed with either laser or destroyed by exposing them to concentrated heat. The blood vessels are then sealed without the help of stitches. The procedure is known as Cauterizing or Vaporizing.
The treating doctors, sometimes, prefer removing scar tissue at this point of laparoscopic surgery. This is done to avoid any possibility of getting endometriosis-related pain because of these.
The entire idea behind going in for Conservative Surgery is treating the Endometriosis and saving the healthy cells around it.
While most of the women suffering from Endometriosis get much relief from pain after the surgery, but there are always chances of returning the pain. The excision of deep lesions seems to be associated with long-term pain relief.
There are evidences available to the fact that women who are suffering from moderate endometriosis get more respite than those who have nominal endometriosis. This happens largely because of the perception of pain before and after the surgery. The women having insignificant growth of endometriosis are generally not able to draw the line between the pain before and after the surgery. And, they always complain about the persisting pain even after the surgery.
The procedure is considered to be a major surgical operation. The endometrial patches are removed by the treating surgeon. Sometimes, the growth is too small to be seen in a laparotomy.
During this method, the treating may remove your uterus. The surgery for removing the uterus is called hysterectomy. If the endometriosis is too severe, the uterus along with ovaries and fallopian tubes is removed completely. The procedure is called “total hysterectomy” or “ bilateral salpingo-oophorectomy”.
Since ovaries have a vital role in the upkeep of overall health, the treating doctors remove them having left with no option.
It would unrealistic to assume that the Endometriosis will not return and the pain will go away forever after hysterectomy or total hysterectomy. It is estimated that nearly 15% of women who have undergone hysterectomy or total hysterectomy experience recurrence of symptoms relating to Endometriosis.
Pelvic nerves surgery
When the endometriosis pain is diagnosed to be located in the middle of the abdomen, your treating doctor may consider severing pelvis nerves for minimizing the pain. The severing is either done using laparoscopy or laparotomy.
There are two kinds of surgeries that are used to severing different pelvis nerves:
In this kind of surgery, the nerves connecting to the womb are severed. Believing the research done on this kind of surgery, the endometriosis patients get much relief in the middle of the abdomen. The patients’ response to this kind of surgery is also encouraging.
Laparoscopic Uterine Nerve Ablation
The abbreviated form of the surgery is called LUNA. In this surgical operation, the nerves securing the womb ligaments are severed. The surgery is not suggested as the results of LUNA are not that encouraging. They do not provide pain relief when compared with the respite provided by the laparoscopic treatment. And, generally not recommended by the experts.
Having done several clinical trials, the American College of Obstetricians and Gynecologists (ACOG) has not found these methods to be effective in relieving pain owing to endometriosis. The College does not recommend this for managing the disease.
In order to reduce pain relating to endometriosis, hormonal therapy is considered useful. Some recent evidences advocate using Intra-uterine Device (IUD) having progesterone after surgery. The Food and Drugs Administration of the US government has approved only one such birth control device called “Mirena”.