Laparotomy for Endometriosis

Overview
Laparotomy is a surgical technique used in cases of severe or extensive endometriosis. Laparotomy is used only when laparoscopy will not provide sufficient access.

What does it involve?
A laparotomy is a wide incision (usually about five inches) along the bikini line through the skin and muscle of the abdomen. A laparotomy allows the surgeon more access to the abdominal organs. For this reason, it may be used in cases of severe endometriosis where lesions are extensive throughout the pelvic cavity. For instance, if the surgeon will need to resection portions of the bowel to remove endometrial implants, they may choose laparotomy over the less invasive laparoscopic technique.

After a laparotomy surgery, you will need to stay in the hospital for several days. It takes about five to six weeks to recover from a surgery performed by laparotomy.

Intended Outcomes
Laparotomy is a technique that may be used to achieve different surgical goals. The intended outcome of choosing laparotomy is to gain maximum access to the abdominal organs.

Results
Laparotomy and laparoscopy are equally effective as surgical techniques for endometriosis. However, laparoscopy usually provides a faster and less painful recovery than laparotomy.

Constraints
Any surgery carries risks including blood clots, blood loss, infection, breathing problems, scarring, reactions to medication, and heart attack or stroke during the surgery. Short-term complications of surgery for endometriosis can include pain in the surgical area, constipation, diarrhea, bladder or vein irritation, nausea, vomiting, fatigue, nightmares, trouble sleeping, headaches, and shoulder pain from gas trapped beneath the diaphragm. Long-term complications can include scarring and adhesions, both of which can affect fertility and necessitate additional surgeries. Also, excision of deep endometrial implants from an organ may cause damage or affect function.

Call your doctor if you notice symptoms of infection such as fever, bleeding, swelling, or increased pain at the incision, or severe abdominal cramping and pain. Notify your doctor if you experience chest pain, shortness of breath, discharge from the wound, abnormal or foul-smelling vaginal discharge, pain or swelling in your calves, painful or frequent urination, or vomiting more than 24 hours after the surgery.

Endometriosis surgery may not be effective in relieving your pain from endometriosis or improving your fertility.