ADVICE NEEDED PLEASE. Difference between Laparoscopy and Laparoscopic Excision surgery?

Hello Ladies

First time posting. I will try and keep this short. I am having an awful time just now with my endo pain. I seen a different consultant today who said I am going to have Laparoscopic excision surgery. I had laparoscopy back in sept 2013 which was when I was diagnosed with Endometriosis where they burnt it off. What I would like to know is , is there a difference? In my mind I was hoping for excision surgery after reading how successful it can be, I am aware that it is a longer operation. Could this be what I am getting. If it is then it is really great news but I don't want to get my hopes up

I would be so grateful if I could get a bit advice on this.


8 Replies

  • Hi

    Yes there's a big difference - your first lap would have been a diagnostic lap, where the surgeon would have been focused on having a look around and mapping any endo, often they will also try to laser away small patches etc but it really is just a diagnostic procedure, not operative treatment of the endo.

    In contrast an excision lap is an actual operative lap to go in and complete surgical treatment of endo by excision (cutting) of the endo. So yes, good news that you will be having excision! If you've got any concerns about the type of surgery you'll be having you should definitely contact your gynae (via his secretary) for confirmation. x

  • Thanks for you reply! Well it is great news. I just wasn't sure as he didn't really go in to great detail or say how long it would take. I wish I could get it done tomorrow, This horrible disease has taken over my life. Hope you don't mind me asking, have you had excision surgery? xxx

  • Hi again

    Yes I have extensive excision surgery last year, was split across 2 ops 8 weeks apart as was very big job, grade 4 endo and everything stuck together and needed bowel surgeon too. Was a slow recovery as had a couple of added complications but getting there now and so far things seem to be going really well, relatively early days still though but things look good so far - fingers crossed it will help you too x

  • Lucky you - yes there is a difference.

    Laser or diathermy burns off a shallow depth of endo only. If the endo is only shallow that's great and it's dead. But for any endo that is deeper than the laser or diathermy reaches, will still remain active under what was attacked by laser.

    Excision Surgery is the ONLY way to remove deep infiltrating endo. It is what the endo experts call the Gold Standard for removing old endo once and for all.

    Regular gynae surgeons tend to use the lasers and the endo expert surgeons use the excision method - which is literally cutting out the endo lesions deep enough to get it all out root cells and all. The post op recovery pains are rather different to those you would experience from laser and diathermy burns.

    It is a bigger op, will take longer to do, and longer to heal inside, but the results are so much better.

    It won't prevent new endo escaping from the uterus and nesting elsewhere, but it sure does remove the existing endo so it cannot regrow from deep endo cells left behind as in previous ops.

    They are both done through lap holes for most cases but I'm sure your doc will explain that there are times where you start off with lap holes, then they spot a really hard to reach area and decide to open you up to do a laparotomy opertion (big hole op).

    That does double the recovery time needed post op, and some. But it really is worth the extra hassle for a job well done. It should save you from any more endo ops for quite some time.

  • I had excision surgery 5 weeks ago today, so if you have any questions feel free to ask. I am off to see my consultant this morning for my follow up too so might know some more later!

    the recovery time for me this time has been slightly longer than before when i just had laser and i found i was a bit sorer but that could just be down to where it was etc but its definately the way forward x

  • Hello, I had total peritoneum excision, op took 5-6 hours was in hospital 3 days as they removed From bladder/bowel, removed a tube and resected my ovaries, I was back to work after 9 days, best thing I ever did xx

  • Burning endo, or ablation it is also called, has only about a 20% success rate as much endo is too complex or deep to be effectively destroyed that way, Excision of endo is removing the tissue completely. The key is that the surgeon not only knows what endo looks like, how it changes over time, where it is statistically located and has the necessary skill and certifications to remove it off bladder, bowel, diaphragm, renal system and other areas not always part of gynecology surgery, Or that they use a multidisciplinary team to deal with it in all of the different areas

  • Thank you for all the replies. Not been on in a while as my mind went in to endo over drive it has taken over! Xxx

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