Laparoscopic Excision of Endometriosis in Charlottesville, VA

Receive the best care for your gynecological health.

What is Laparoscopic Excision of Endometriosis?

If you suffer from endometriosis, laparoscopic excision can eliminate or significantly reduce symptoms and improve your quality of life. In brief, It’s a minimally invasive surgical procedure involving small abdominal incisions to identify and remove lesions and scar tissue caused by endometriosis.

Endometriosis is a chronic medical condition that occurs when tissue similar to the lining of the uterus (endometrium) grows outside the uterus. The condition can cause a variety of symptoms, including pelvic pain, painful menstrual periods, pain during intercourse, and potentially fertility problems.

The purpose of laparoscopic excision is to remove all visible endometriosis and repair any affected areas, providing pain relief and improving fertility. The recovery from this procedure is faster than some other treatment options, has fewer complications, and better outcomes.

Benefits of Laparoscopic Excision of Endometriosis

Minimally invasive (incisions 1 cm or less)
Potential for long-term relief
Improved overall quality of life
Reduced pain
Improved fertility
Enhanced symptom management
Short or no hospital stay
Reduced need for pain medication

How is Endometriosis Diagnosed?

During your consultation, Dr. Barron will ask about symptoms you have been experiencing, conduct a pelvic exam, and potentially use an ultrasound to conduct an expert level evaluation for endometriosis or other causes of pelvic pain.

The most definitive way to diagnose endometriosis is through a laparoscopy, a surgical procedure where a narrow camera lens is inserted into the abdomen to visualize and confirm the presence of the disease.

Additional Treatment Services For Endometriosis

In addition to laparoscopic surgery, other treatments for endometriosis can include the below:
Pain Medications: Over-the-counter pain relievers (such as ibuprofen and naproxen) can help manage pain and discomfort.

Hormone Therapy: Hormone treatment such as birth control pills, progesterone only pills, or hormonal IUDs can regulate menstrual cycles and potentially stabilize and reduce endometrial tissue growth and pain symptoms,1 however, no studies have conclusively demonstrated that these medications can destroy or eliminate endometriosis nor improve pregnancy rates.2,3,4

Hysterectomy: In severe cases or when other treatments are ineffective, removal of the uterus and possibly the ovaries might be recommended in addition to excision of endometriosis.

Lifestyle Changes: Diet modification, supplements, and exercise can sometimes provide symptom relief.

If Dr. Barron suspects you have endometriosis, treatment will be highly personalized based on your specific needs and symptoms.

What To Expect

In anticipation of your visit we ask patients to complete a comprehensive pain questionnaire that Dr. Barron will review before your visit. We also like to have records from prior providers and copies of operative reports from any previous surgeries. At your initial visit, Dr. Barron will conduct a medical evaluation and pelvic exam. If you are found to be a candidate for laparoscopic surgery, you will return either in person or virtually for a pre-operative visit before your surgery. During surgery you’ll be under general anesthesia. Through small incisions on the abdomen a small instrument known as a laparoscope will be inserted into your abdomen to evaluate the abdomen and pelvis for endometriosis or other causes of pelvic pain. After a thorough survey, endometrial disease is then removed via excision/resection.

It’s common for patients to experience abdominal pain and fatigue after treatment. The most bothersome pain is in the first 48 hours after surgery. The majority of postsurgical pain is from the incision through your abdominal wall. Patients often feel like they have done a 1000 situps. Fatigue takes longer to resolve: typically 2-6 weeks. We routinely see patients back in the office for a postoperative visit at 2 weeks to check on incisions, discuss the surgery, pathology results, and steps for any ongoing treatment.

What are the Risks of Laparoscopic Endometriosis Excision?

The risks of laparoscopic endometriosis surgery can include bleeding, infection, damage to surrounding organs, anesthesia complications, and the potential for scar tissue. Dr. Barron will thoroughly discuss potential risks with you before beginning treatment.

Why Choose The Center For Advanced Gynecology

The Center for Advanced Gynecology, established in 2018, is dedicated to improving your health by offering expertise in various areas, with a specific focus on gynecological care and advanced surgical techniques when surgery is needed. Dr. Barron has been focused on endometriosis surgery since 2016 after extensive training beyond a general residency in obstetrics and gynecology. He is a sought after surgeon in the mid-atlantic region because of his skill, experience, and bedside manner.

Our team also provides specialized expertise in non-surgical treatment of chronic pelvic pain, painful intercourse, pudendal neuralgia, and vaginal, vulvar, and bladder pain.

Frequently Asked Questions

Endometriosis symptoms can include the following. If you have endometriosis, you might experience all of the symptoms or only a few at a time.

Pelvic pain
Very painful menstrual cramps during your period (dysmenorrhea)
Pain during or after intercourse (dyspareunia)
Heavy menstrual bleeding
Gastrointestinal symptoms (diarrhea, constipation)
Fatigue
Infertility or difficulty conceiving
Painful urination during menstruation
Lower back pain
Painful bowel movements during menstruation
Severe bloating

Recovery from laparoscopic endometriosis surgery varies, but generally involves a few days of rest, with most patients returning to normal activities within two weeks.

While laparoscopic excision of endometriosis can remove existing lesions and significantly improve symptoms and quality of life, it’s possible for lesions to return. The most reliable published research suggests a recurrence rate of 20% at 2 years and 50% at 7 years¹

Yes, surgical treatment of endometriosis has been shown in numerous studies to improve natural pregnancy rates. As an example, an endometriosis referral center in Hannover Germany reported that 65% of patients desiring pregnancy after excision surgery became pregnant.²

We will provide you with an information packet on preparing for surgery with specific instructions prior to your procedure. This will include discontinuing some medications, fasting, and other pre-operative steps.

Dr. Barron operates on many patients who have traveled far distances for his expert surgery. We often see patients virtually (telehealth) for an initial visit/record review. If additional imaging is needed, we will arrange for you to get necessary studies locally. We then ask you to arrive in Charlottesville one day before your surgery to be seen for an exam and preoperative visit. After your surgery we advise you to stay in town (in a hotel) for 48 hours after your surgery or discharge from the hospital. Post-operatively, we plan a virtual visit or in person visit at 2 weeks. If an exam is needed we either ask you to return to our office or arrange for your local gynecologist to see you for a postoperative visit.

We typically see patients for a postoperative visit at 2 weeks or sooner if needed.

Yes, endometriosis can recur, requiring ongoing management or additional treatment. Complete excision decreases the chance of a recurrence. The most reliable published research suggests a recurrence rate of 20% at 2 years and 50% at 7 years¹

Diagnostic laparoscopy is a minimally invasive procedure that provides a direct visualization of lesions inside the abdomen and pelvis. It can confirm the presence and extent of the disease. In its true form, a diagnostic laparoscopy is only to confirm the diagnosis but does not treat the disease. At the Center for Advanced Gynecology we believe that a diagnostic laparoscopy is never appropriate. If a doctor offers you a diagnostic laparoscopy then they are not confident in their ability to treat what they might find and you should seek a second opinion. Appropriate pre-surgical evaluation to assess for involvement of the intestines, the ureters, and extra-pelvic endometriosis should be done before entering the operating room so that diagnosis and treatment can be completed during the same medical treatment procedure.

References

Agarwal SK, Foster WG. Reduction in endometrioma size with three months of aromatase inhibition and progestin add-back. Biomed Res Int 2015;2015:878517.
Practice bulletin no. 114: management of endometriosis. Obstet Gynecol. 2010 Jul;116(1):223-236.
Becker CM, Bokor A, Heikinheimo O, Horne A, Jansen F, Kiesel L, King K, Kvaskoff M, Nap A, Petersen K, Saridogan E, Tomassetti C, van Hanegem N, Vulliemoz N, Vermeulen N; ESHRE Endometriosis Guideline Group. ESHRE guideline: endometriosis. Hum Reprod Open. 2022 Feb 26;2022(2):hoac009.
Practice Committee of the American Society for Reproductive Medicine. Treatment of pelvic pain associated with endometriosis: a committee opinion. Fertil Steril. 2014 Apr;101(4):927-35. Erratum in: Fertil Steril. 2015 Aug;104(2):498.
Shakiba K, Bena JF, McGill KM, Minger J, Falcone T. Surgical treatment of endometriosis: a 7-year follow-up on the requirement for further surgery. Obstet Gynecol. 2008 Jun;111(6):1285-92. Erratum in: Obstet Gynecol. 2008 Sep;112(3):710. PMID: 18515510.
Schippert, C., Witte, Y., Bartels, J. et al. Reproductive capacity and recurrence of disease after surgery for moderate and severe endometriosis – a retrospective single center analysis. BMC Women's Health 20, 144 (2020).