What
What is Severe Endometriosis?
Endometriosis is a disease caused by endometrial tissue growing outside the uterine cavity. Severe endometriosis usually refers to deep infiltrating endometriosis (DIE), where lesions infiltrate to a depth of ≥5mm, potentially affecting the sacral ligaments, rectum, bladder, ureters, causing severe dysmenorrhea, chronic pelvic pain, dyspareunia, infertility, and bowel and urinary symptoms, greatly impacting quality of life and mental health.
This disease greatly affects quality of life and mental and physical health.
Why is laparoscopic/endoscopic surgery needed?
Medication can control symptoms but cannot cure, and symptoms easily recur after stopping medication. For severe endometriosis, laparoscopic surgery is the 'gold standard' for diagnosis and treatment.
High-definition magnified view
Precise excision
Anatomical restoration
Combined surgery
How
- Comprehensive Preoperative Assessment: Detailed inquiry of medical history, gynecological examination, combined with pelvic ultrasound, MRI, and other imaging studies to accurately assess endometriosis staging, classification, and infiltration depth.
- Multidisciplinary Team Consultation (MDT): For complex cases, initiate MDT discussion to jointly develop an individualized surgical plan and contingency plan.
- Preoperative Preparation: If necessary, conduct colonoscopy, urinary tract imaging, and other examinations, and perform bowel preparation.
- Undergoing Laparoscopic Surgery: Performed under general anesthesia. Establish pneumoperitoneum, insert laparoscope, explore pelvic and abdominal cavity, precisely excise all visible lesions, separate adhesions, and restore anatomy.
- Postoperative Recovery: Encourage early mobilization after surgery, with a hospital stay of approximately 3-5 days.
- Long-term Management and Follow-up: Endometriosis is a chronic condition, requiring long-term medication management (such as GnRH-a, dienogest) post-surgery as per medical advice to prevent recurrence, with regular follow-ups.
Recovery
FAQ
Can surgery cure endometriosis completely? Will it recur?
Endometriosis, due to its 'infiltration and metastasis' characteristics similar to malignant tumors, cannot currently be guaranteed to be cured, and there is a possibility of recurrence. The recurrence rate is closely related to the severity of the disease, the thoroughness of the surgery, and whether postoperative management is standardized. Our goal is to maximize the delay of recurrence through extremely meticulous complete excision surgery and standardized long-term medication management, allowing patients to achieve a long-term, symptom-free, high-quality life.
Will the surgery affect my fertility?
Our surgical principle is 'fertility preservation first.' For patients with fertility needs, the surgery will be extremely meticulous to avoid damaging normal ovarian tissue and the uterus. The surgery itself, by removing lesions and improving the pelvic environment, is beneficial for pregnancy. For patients who still require assisted reproductive technology post-surgery, we will closely collaborate with reproductive specialists to choose the optimal timing.
How is surgery performed if the lesions invade the intestines or bladder?
This is precisely where our multidisciplinary team (MDT) adds value. Superficial lesions: lesion excision ('shaving'). Deep infiltrating lesions: if only part of the intestinal wall muscle layer is invaded, a disc excision (removal of the lesion, suturing of the intestinal wall defect) can be performed; if the entire intestinal wall layer or a large area is invaded, a general surgeon is needed to perform a bowel segment resection and anastomosis. The same applies to bladder lesions. The MDT team ensures the safety and thoroughness of such complex surgeries.