Treatments

Laparoscopy

Laparoscopy is a type of surgical procedure that allows a surgeon to access the inside of the abdomen and pelvis without having to make large incisions in the skin. This procedure is also known as keyhole surgery or minimally invasive surgery.

The surgeon uses an instrument called a laparoscope. This is a small tube that has a light source and a camera, which relays images of the inside of the abdomen or pelvis to a television monitor. The advantages of this technique over traditional open surgery include a shorter hospital stays and faster recovery time, less pain and bleeding after the operation and reduced scarring.

A diagnostic laparoscopy may be needed if you remain in persistent pelvic pain, even if all investigations are negative. Laparoscopy is the ‘gold standard’ for diagnosing endometriosis as you can see small endometriosis lesions (superficial endometriosis), treat them at the same time and refer for histological confirmation.

In severe endometriosis, we consider a deep-excision of the disease, including the tissue underneath the surface. Deep endometriosis is like an iceberg; most of the disease lies implanted underneath the surface tissue. Ablation or cauterisation increases the chance of not entirely removing the endometriosis lesions and risks damaging the surrounding healthy tissue. This is why excision surgery is the gold standard for treatment. It is a common myth that having a hysterectomy (removal of the uterus) will cure endometriosis as by definition endometriosis is located outside the uterus. The simple hysterectomy without the excision of the remaining lesions will lead to a persistent disease and pain. Decisions regarding hysterectomy should be made according with our diagnostic findings. If severe endometriosis involving the bowel or urinary system is found, the operative laparoscopy may be delayed, so the bowel or bladder can be prepared for surgery and specific consent to bowel or urinary surgery obtained.

For us, it is crucial that you understand your treatment options with risks and benefits and that we can agree together on the best management in your situation. The treatment is always tailored to your specific circumstances, and it will depend upon your age, fertility requirements and symptoms.

Initial Conversation

After our diagnostic pathway, we can discuss treatment options with you and make the right decision for you and your symptoms. If surgery is indicated in your case, a further explanation on risks and benefit will be carried over. We perform minimally invasive surgery and only in very specific cases we proceed with open surgery. If any investigations or treatments inside the uterine cavity are needed, we perform a procedure called hysteroscopy.

Hysteroscopy

Hysteroscopy is the procedure used to examine the inside of your uterus. It's carried out using a hysteroscope, which is a narrow telescope with a light and camera at the end. The instrument is passed into your womb through your vagina. It can be diagnostic or operative when we perform some treatments in case of abnormality.