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Enduring Endo: Understanding the Risks Behind a Laparoscopy

Written by Claudia Lipinski


For women suffering from endometriosis and other reproductive issues, there comes a time when they may need to make a life-changing decision: whether or not to undergo laparoscopic surgery. The purpose of this procedure is to diagnose a variety of pelvic, abdominal and gynecological conditions by using a laparoscope, a long and narrow viewing instrument (similar to a telescope). The laparoscope is inserted into one’s abdomen by means of a small, surgical incision. This will allow a doctor to view tissue and/or collect a tissue sample (otherwise known as a biopsy). More specifically, a laparoscopy happens to be the only way to accurately diagnose a woman with endometriosis. This surgery may also be utilized to remove scar tissue, cysts and implants that were brought on by endometriosis.




Doctors may decide to recommend laparoscopic surgery to a patient, especially if they believe that endometriosis is present, for multiple reasons:

  • Infertility

  • Severe abdominal pain

  • Abnormal masses found on the ovaries

  • Organ dysfunction (for instance, related to the bladder or bowel)

  • Uncontrolled bleeding caused by menstrual irregularities

  • Pelvic Inflammatory Disease (PID) or chronic pelvic pain

  • Removal of fibroids, lymph nodes and ovarian cysts

  • Ectopic pregnancy

  • Recurring symptoms following hormonal therapy

  • Urinary incontinence

  • Evaluating ovarian, cervical or uterine cancers


Women who have been encouraged to undergo a laparoscopy are often told by doctors that it is a minimally invasive procedure, as opposed to an open surgery, which is more painful and has a higher risk of infection.


Additionally, a laparoscopic surgery (also referred to as “keyhole surgery”) heals at a faster rate and usually involves the use of general anesthesia, implying that patients are completely asleep during this procedure. Plus, if overnight monitoring isn’t needed, most patients are released from the hospital within the very same day. That doesn’t sound so bad, right?


But how can we know for sure that a laparoscopy will permanently “remove” endometriosis and won’t cause further complications within the body? Unfortunately, that sense of certainty often slips through our fingers since there is zero guarantee that endometriosis won’t reappear.

Yes, you read that right. Even after undergoing a laparoscopy, endometriosis can still come back, sometimes within a span of just two years following this diagnostic procedure. The remaining tissue can very likely grow back in time, since it is not possible to eliminate every single cell of the misplaced tissue. To make matters worse, this minimally invasive procedure can actually pose a threat to the body’s internal structures. Possible organ damage to the stomach, bowel, major arteries, bladder, or ureter can occur during and after a laparoscopy. In addition, patients can be at risk for infections, hernias, blood clots, nerve damage, allergic reactions to anesthesia, fainting and scarring.





In more severe cases, the usage of carbon dioxide throughout the laparoscopy can complicate things even further, such as gas bubbles entering blood vessels and/or irritating the diaphragm. Going back to the damage that can occur within internal structures, the bladder can be drastically affected post-surgery, since some claim they are unable to properly urinate afterwards.


In regards to vaginal complications, heavy menstrual bleeding and abnormal discharge have also been found to occur. Let’s not forget about issues that can potentially arise when it comes to the site of the incision itself, following laparoscopic surgery. Bruising, redness, bleeding, swelling, discharge and overall increased pain around the incision has been known to occur during recovery.


Because the exact cause of endometriosis is yet to be determined, a path that may work for one person may not necessarily work for another. When it comes to treating endometriosis, every patient’s treatment and healing process should be customized to their individual health concerns. At the end of the day, a laparoscopy may not be the best choice for every woman.



There are alternative, even less invasive, forms of treatment that a doctor can prescribe to a patient, such as hormone therapy. A holistic approach towards treatment is also an option. As overwhelming as the short and long term risks of a gynecological laparoscopy are, being educated on the pros and cons of this procedure can ultimately allow a woman to make the best possible decision for her body and well-being.


References

Bergen, T. (2018, September 29). Gynecologic laparoscopy: Purpose, procedure, and risks. Healthline. Retrieved March 28, 2022, from https://www.healthline.com/health/gynecologic-laparoscopy

Johnson, T. C. (2020, June 17). Laparoscopic surgery for endometriosis: Procedure, risks, recovery. WebMD. Retrieved March 27, 2022, from https://www.webmd.com/women/endometriosis/laparoscopic-surgery#091e9c5e8147fab0-2-6 Smith, L. (2018, May 24). Laparoscopy (pelvic): Uses, risks, and benefits. Medical News Today. Retrieved March 28, 2022, from https://www.medicalnewstoday.com/articles/308285

Tayal, S. (2018, September 3). Laparoscopy or open surgery? Which is best for me? Fortis Health Connect Blogs. Retrieved March 27, 2022, from https://www.fortishealthcare.com/blog/laparoscopy-open-surgery-me/

Vandergriendt, C. (2018, September 18). Laparoscopy for endometriosis: Procedure, recovery, and more. Healthline. Retrieved March 27, 2022, from https://www.healthline.com/health/endometriosis/laparoscopy-for-endometriosis

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