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da Vinci ® Endometriosis Resection at Our Los Angeles Center

Endometriosis surgery is one option for removing endometrial tissue that is found growing outside of the uterus (along with related scar tissue adhesions). It may offer long-lasting relief for a problem that hundreds of thousands of women deal with every month. Endometriosis is a health condition that has long confused and challenged medical researchers. At one time, the pain associated with this disease was simply ignored. Women who complained of crippling premenstrual pain were simply thought to be exaggerating. Thankfully, the condition is now recognized as real and the underlying cause of the pain has been identified.

Endometriosis Basics

The type of cells that normally line the uterus and which are shed during menstruation can sometimes begin to multiply in other locations outside the uterus. These non-cancerous growths cause the development of scar tissue adhesions on the surface of surrounding organs and connective tissues in the pelvic region, resulting in severe pain. The pain usually starts before menstruation and continues for several days. The amount of discomfort patients suffer from may vary from one month to the next, and there appears to be little relation between the size of the adhesions and the amount of pain. Some patients can have very advanced endometriosis with no symptoms while others have a mild stage that causes significant discomfort. Unfortunately, doctors still don’t know what causes abnormal endometrial tissue growth, how it reaches sites outside the uterus or how to prevent this from happening. All they can do is treat the symptoms and/or try to remove the “maverick” endometrial tissue and scar tissue.

Options for Endometriosis Treatments

Most women start with over-the-counter and at-home remedies like heating pads and non-steroidal anti-inflammatory meds (such as Motrin). However, these are usually inadequate for managing the symptoms of endometriosis.

Many women experience a cessation of their symptoms with the use of birth control hormones that suppress ovulation. Estrogen and progesterone medications prevent monthly flare-ups of endometrial pain and keep the condition from worsening. However, not all women are candidates for birth control. These hormones can be dangerous for women who are at risk for blood clots. They also carry the potential for unwanted side effects that may include weight gain, acne and mood swings. Symptoms generally return after the hormones are stopped and regular menstruation resumes.

Hysterectomy surgery (removal of the uterus) with oophorectomy (removal of the ovaries) may be an effective treatment since it completely removes the organs involved in the production and growth of endometrial tissue. However, removing the ovaries causes instant menopause by shutting down the body’s naturally occurring supply of estrogen. Although many women do undergo hysterectomy for endometriosis, this is generally considered a last resort if other treatments fail. If a woman is close to menopause, she may wish to simply let nature take its course. Endometriosis symptoms tend to lessen substantially or disappear entirely once menstruation stops at menopause.

For younger women who don’t want a hysterectomy, a less drastic surgical approach is endometriosis surgery, known as the endometriosis resection. Instead of taking out a woman’s entire reproductive system, the areas of adhesion are carefully targeted for resection (removal). Since laparoscopic surgery is now very prevalent, the recommended approach to endometriosis surgery is usually minimally invasive. If the removal process is not too complex and the target areas are accessible, laparoscopy can offer good results with a short recovery period.

Unfortunately, removal of endometrial tissue can often be very involved. There may be many growths throughout the pelvic region and some of them may be difficult to visualize and access using the rigid tools and standard video quality of laparoscopic equipment. Any tissue left behind can cause symptoms to continue, making the surgery a failure from the patient’s perspective.

Who Is a Candidate for da Vinci Endometriosis Resection?

Women who have endometriosis that is severe enough to interfere with their quality of life or that is contributing to infertility may be candidates for da Vinci robotic endometriosis surgery. Patients typically report one or more of the following symptoms that start before menstruation each month and continue for several days:

  • Severe cramping (stabbing, throbbing or aching pains in the pelvis)
  • Irregular menstrual cycles
  • Excessive bleeding during menstruation
  • Pain during sex
  • Pain during evacuation (bowel movements or urination)
  • Lower back pain
  • Diarrhea or constipation (sometimes both within a couple of days)

 

The da Vinci technology may be especially helpful for women who have put off surgery for a long time. They may have widespread and deeply penetrating endometrial adhesions that are difficult to remove via laparoscopy. The minimally invasive robotic approach may help these patients avoid a more invasive open surgery such as a hysterectomy.

Patients who are candidates for this surgery are those who want to preserve their reproductive organs while removing abnormal tissue. Individuals who have adhesions on their ovaries or fallopian tubes may seek surgery to help restore fertility. The high level of precision afforded by the da Vinci robotic equipment may be beneficial in protecting these delicate tissues from damage during surgery.

Benefits of Endometriosis Resection

The state-of-the-art da Vinci Surgical System offers miVIP Los Angeles surgeons unparalleled precision in locating and removing endometrial adhesions – even in hard-to-reach locations. Patients who undergo this surgery may enjoy:

  • Minimal scarring due to small incision size
  • Very little blood loss during surgery
  • A low risk of complications during or after the operation
  • No hospitalization required

 

Patients may experience a reduced risk of recurrence due to more complete removal of endometrial tissue with this detailed surgical approach. However, it is important to bear in mind that there is always a risk of recurrence after endometriosis surgery. In fact, not even hysterectomy can completely guarantee that symptoms will not return. Even so, removing as much of the growths as possible during surgery may make disease management with other therapies such as hormones more effective afterward.

The recovery from this minimally invasive operation is a testament to how far medical technology has advanced. Some patients have reported using only ibuprofen after their da Vinci endometriosis resection procedure because their post-operative pain was minor. Obviously, the results are different for each patient. The details of recovery may vary depending on how invasive the adhesions are; but the overall experience is typically very manageable. This is a good reason for women who have been delaying effective treatment of their endometriosis to explore the potential of the da Vinci. Within just a month of the procedure, they might have a pain free period for the first time in years!

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