What to expect with a laparoscopic excision surgery.
Disclaimer: I am not a doctor, the following is all from my own laparoscopic excision surgery, and from what I’ve heard from others’ experiences.
Your first laparoscopic excision surgery can be scary. If we’re honest- most surgeries can be scary, whether it’s your first time or not!
When it comes to endometriosis, one of the options you might have is to have laparoscopic excision surgery to remove endometriosis growth by digging out the root of the growths. When done right, it can be incredibly effective in improving symptoms and fertility.
So what should you expect? Well, I can tell you what my surgery looked like, and what I’ve heard many others experience was. Just know that everyone’s experience is bound to have at least a couple differences, but it is helpful to have an idea of what you might encounter if you’ve never gone through it before.
Pre-op:
Typically, you will schedule your surgery with the doctor or endometriosis specialist you’ve seen for your initial appointments. They should give you specific instructions for any preparations you need to take before you arrive at the hospital for your surgery. For me, I was emailed instructions to not eat or drink anything after 12 am on the day of my surgery. (I know others who have had to also do a bowel prep, but I did not have to do this.)
When you arrive at the hospital, you’ll check in and they’ll take you back to get your weight and height- standard- and then take you to your room. Here they will take your blood for a blood test to make sure everything is okay to proceed, and then ask you to change into the robe given to you and climb into the bed. Once you’re situated, they’ll hook up an IV while you wait for your surgery!
On the day of my surgery, my doctor and the anesthesiologist came in and talked through what was going to happen with me and my husband, Nate, and my mom before taking me back to the operating room. (They were both allowed in the room with me, but it was very cramped!) I was then wheeled back to the surgery room, where I remember being very cold, so the nurses ran and grabbed me extra blankets!
Surgery:
To be honest, once I was in the operating room- I started to get nervous. It was so white and felt cold, sterile, and uninviting. I was on edge as they transferred me to the operating table, surrounded by a team of people hovering over me, looking into these bright lights above me. But the anesthesiologist was so kind and comforting; he asked me questions about my life and reminded me that I was in the best hands. I believe he had me count down from ten (either that, or list something off- but I can’t remember!) and before I knew it, I was out.
You will be asleep during your laparoscopic surgery, and therefore shouldn’t feel a thing. For the laparoscopic surgery, usually what will happen is the surgeon will make an incision in your abdomen, (for most women I’ve talked to, and myself included, it’s been in the bellybutton) and they’ll likely make one or two other small incisions for more access (I had two more incisions made- one right next to each hip bone). They will then fill your belly with gas, so that it expands and they are able to have a clear view of everything happening inside.
Next, they insert the laparoscope (which is a camera with a light), and they’ll insert the tools needed for excision. Depending on what they find, the surgery could take anywhere from 30 minutes to 6 hours. Laparoscopic surgery is so important in diagnosing endometriosis because surgeons can find and identify growth that would have otherwise never been picked up by any other means. With excision surgery, your surgeon will go in and essentially cut and dig out any growth and the root of it. It is a tedious process that requires precision and care! They will also take endometriosis growth that they remove during this time, and send it to the lab to be tested for cancer.
After they are finished with the surgery, they will remove the laparoscope, surgery tools, and gas and close up your incisions with stitches, skin glue, or surgical tape. You’ll then be taken to the recovery area until the anesthesia begins to wear off, and then back to the room you started in until they release you.
Post-op:
Plan on having someone there with you the day of your surgery for a couple reasons: 1) you’ll be coming off anesthesia and will need someone else to get you home safely, and 2) you likely won’t be mentally present enough to hear, understand, or remember anything that is communicated to you after the surgery (at least I wasn’t!) But also- it’s just nice to have a comforting face to wake up to when you’re feeling a little confused and groggy and potentially in some pain.
The doctors should prescribe some medication for pain for you to take at home, so plan on having someone pick that up for you as well. Once you’re home, climb into bed and get some rest! Something I didn’t really expect and was unaware of was the gas pain that would occur after the surgery. It is usually caused by gas still trapped in your diaphragm, which can cause pain in your chest, shoulders, and back when breathing. It can last a few days after your surgery, so be prepared with some gas relief medication, and warm liquids such as peppermint tea or some soup! Getting up and walking around every so often can also be helpful- even if it’s just around the room to the door and back to the bed.
Your doctor will likely schedule a post-op check up with you- mine was the following week. They will do another blood test, check your incisions, and talk through the results of your surgery. My doctor had taken MANY (and I mean many) photos of everything that was happening inside my body- he showed me every single bit of endometriosis that he removed, the toxic blood pools that he drained, and my uterus back in its rightful place. They also scheduled my six month check-up appointment!
Long-term:
Surgery for endometriosis (or other issues) is different for everyone- from beginning to end. There are bound to be some similarities, as well as lots of differences, whether big or small. I felt sore and weak in my abdomen and pelvic floor for a while after the surgery- it took me several months to feel like I was at 100% of my physical operating state. I know others for whom full recovery took a year, and others for whom recovery took one month.
There’s no formula for these things- which can be frustrating. It’s hard to be patient with yourself after a surgery like this and not be mad that it’s not operating a certain way or meeting whatever expectations you may have had. But learn to care for yourself in those moments. Let your body take the time that it needs to heal and grow strong, and have compassion on yourself. Take things one day at a time- celebrate the wins, and have grace for rough days. Listen to your body and how it’s communicating to you.
I am three years post my first laparoscopic excision surgery- and it was the best decision we ever made. That’s not to say things are perfect now- I have had several conversations with Nate the last six months about my flare-ups and pain and not knowing when the right time is to make the decision on having another surgery. But I have learned so much about my body in the last three years, and the surgery changed our day-to-day lives in incredible ways. It freed me, and Nate, from the constant pain I was experiencing and allowed me to actually live and enjoy life again. I didn’t realize just how bad things were until after recovering from surgery!
We are taking things one day at a time. We are celebrating the wins and doing our best to take full advantage of the good days; and trying not to live in a place of anxiety and distrust (for example- I don’t trust this good feeling in my body- am I going to start cramping in a minute? Am I going to have a flare-up?) And I’m learning how to practice self-compassion when I have flare-ups, random cramps, pain-filled days where my body just hurts, bad periods, etc. I am getting better at prioritizing rest, self-care, and kindness towards my thoughts, emotions, and body- and I don’t know how or why- but it legitimately helps. It makes the bad days just a little bit better each time.
I hope this helps some of you who might be preparing for your first laparoscopic excision surgery. Like I said- everyone’s experience usually differs, but hopefully this is enough information to answer any big questions or ease any uncertainties. Please don’t hesitate to reach out with questions or your own laparoscopic experience! And if you need a doctor for endometriosis concerns, listed below are two surgeons who are very skilled and reputable in the world of endometriosis care.
Endo Surgeons:
Dr. Kanayama // New York Endometriosis Center // gynecosurgery.com (New York, NY)
Dr. Nicholas Fogelson // Northwest Endometriosis and Pelvic Surgery // nwendometriosis.com (Portland, OR)