Endometriosis Surgery—Procedure Types and What To Expect

The diagnosis of endometriosis hinges on both the stage of the ailment and its impact on the body. This disorder involves the development of cells resembling the uterine lining (endometrium) outside the uterus, specifically on adjacent organs like the intestines, ovaries, and fallopian tubes. The presence of these abnormal tissues gives rise to pain and irregular menstrual cycles. As the condition advances, surgical intervention might become necessary to excise the aberrant tissue, fibrous adhesions, and cysts.

The predominant classification system employed is the four-stage scale devised by the American Society of Reproductive Medicine (ASRM). This system categorizes endometriosis into four stages: minimal, mild, moderate, and severe.

Tiegen’s Endometrosis Surgery

Chrissy Teigen recently shared her hospitalization due to pregnancy-related excessive bleeding, leading to a heartbreaking miscarriage of her anticipated third child with spouse and singer John Legend. Presently, Teigen, aged 35, finds herself back at the hospital, this time undergoing endometriosis surgery.

Announcing the impending surgery a day earlier on Twitter, Teigen shared a poignant message. She revealed that her surgery coincided with the original due date of her unborn baby, Jack. She expressed, “My little jack would have been born this week so I’m a bit off.” Teigen noted that she perceives sensations resembling kicks in her belly, which aren’t mere illusions. Despite her upcoming endometriosis surgery, she described the feelings this month as reminiscent of baby kicks, expressing a sense of melancholy.

In a subsequent tweet, Teigen sought insights from her followers about their encounters with endometriosis surgery. She humorously inquired about the difficulty level of recovery, even pondering if she would be capable of making soup afterwards.

Her inquiry garnered a multitude of responses, including a message from fellow notable figure and endometriosis sufferer, Padma Lakshmi, the host of Top Chef. Lakshmi, who has undergone five surgeries herself, extended her support, inviting Teigen to connect for a detailed discussion. Lakshmi amusingly suggested that John should take charge of making the soup.

Endometriosis and Surgery

Endometriosis is a prevalent condition that affects a significant portion of individuals with uteruses. According to the US Office on Women’s Health (OWH), estimates suggest that over 11% of those aged 15 to 44 in the US experience endometriosis. However, this number might not be entirely accurate due to potential cases without confirmed diagnoses. Here’s an insightful overview of the reasons behind endometriosis-related surgeries and what they entail.

Endometriosis, colloquially known as “endo,” involves the growth of tissue similar to the uterine lining outside the uterus, on regions where it doesn’t belong, such as the ovaries and fallopian tubes. Although more common among individuals with uteruses in their 30s and 40s, endometriosis can affect even younger individuals, including girls as young as 15.

Symptoms of endometriosis, as outlined by the OWH, encompass painful menstrual cramps, persistent pain, irregular bleeding or spotting between periods, and even digestive disturbances. Among these digestive issues are experiences like diarrhea, constipation, bloating, and nausea. In severe instances, endometriosis can lead to infertility.

Although medical interventions like hormonal therapies can alleviate pelvic pain stemming from endometriosis, surgical approaches might be necessary for certain patients. According to Anita Sit, MD, the head of gynecology at Santa Clara Valley Medical Center in San Jose, California, surgery could be recommended for reasons including attempts at conception, a family history of the condition, painful periods, discomfort during intercourse, or the presence of ovarian cysts. Similarly, Linda Sung, MD, chief of the Division of Reproductive Endocrinology and Fertility at NYU Langone Hospital, Long Island, emphasizes that endometriosis surgery might also be indicated for infertility assessment and treatment, or for the removal of endometrial tissue affecting the functionality of other organs like the bladder.

Ultimately, endometriosis surgery serves various purposes, ranging from enhancing fertility prospects to addressing painful symptoms and maintaining overall organ health.

Laparoscopy Procedure

The primary surgical intervention employed to treat endometriosis is a procedure known as laparoscopy, also referred to as keyhole surgery or minimally-invasive surgery. Administered under general anesthesia, laparoscopy facilitates an enhanced view of the abdominal and pelvic regions through small incisions. A slender instrument called a laparoscope is inserted into these incisions, enabling the surgeon to examine and address any implants, scar tissue, or endometriomas.

The procedure encompasses several objectives, as outlined by Dr. Sung. These aims include alleviating pain, improving fertility, and reducing the extent of endometriosis through resection or ablation. Mayo Clinic notes that laparoscopy frequently results in comprehensive endometriosis treatment, eliminating the need for additional surgeries. Dr. Sit adds that, on occasions, growth implants caused by endometriosis can be excised intra-abdominally through laparoscopy or robotic-assisted surgery.

In addition to its therapeutic role, laparoscopy can serve as a diagnostic tool for endometriosis. The disease is categorized into stages ranging from stage 1 (minimal) to stage 4 (severe), although it’s important to note that these stages differ from cancer staging and don’t hold prognostic significance. The assigned stages don’t necessarily reflect the intensity of chronic pain or infertility experienced by the patient. Furthermore, they don’t inherently provide tailored guidance for treating endometriosis across different patients. As clarified by Hugh Taylor, MD, Vice President of the American Society for Reproductive Medicine and Chair of Obstetrics, Gynecology, and Reproductive Science at Yale School of Medicine, endometriosis stages don’t directly correlate to the management strategies or impact of the condition.

Laparotomy Procedure

An alternative surgical approach for addressing endometriosis is known as a laparotomy, a substantial procedure that necessitates an incision in the abdominal wall. This technique is often characterized as open surgery due to the sizeable incision involved. The purpose of this incision is to grant the surgeon direct access to the abdominal cavity, facilitating the identification and resolution of critical issues. Laparotomies, however, are relatively infrequent and are typically reserved for cases in which laparoscopy is not a straightforward option for treatment.

Hysterectomy Procedure

Lastly, among the surgical options for managing endometriosis, hysterectomies are available, though they are typically regarded as a “last resort,” according to insights shared by Sawsan As-Sanie, MD, a gynecological surgeon at the University of Michigan’s Von Voigtlander Women’s Hospital, in a previous conversation with Health.

During a hysterectomy, the surgeon removes the uterus (womb). In certain instances, the ovaries and fallopian tubes might also be extracted, as detailed by Dr. Sit. This procedure brings an end to menstruation, irrespective of the patient’s age, and renders pregnancy impossible. Beyond severe endometriosis cases, reasons for considering a hysterectomy encompass abnormal bleeding, uterine prolapse, and cancer, as noted by Cleveland Clinic. Notably, the recuperation period for a hysterectomy tends to be longer, spanning about four to six weeks, compared to other types of endometriosis surgeries.

The rationale behind contemplating a hysterectomy as an endometriosis treatment is rooted in the belief that the removal of the uterus would alleviate the incapacitating symptoms. However, this outcome is not guaranteed. Dr. As-Sanie explained, “For many individuals with uteruses, [a hysterectomy] brings relief. If they had heavy, painful periods before, hopefully, this will stop and their pain gets a lot better, although there’s no guarantee.” Nonetheless, a notable percentage, ranging from 10% to 25%, of individuals with endometriosis who undergo hysterectomy still report persisting pain after the surgery. The exact cause of this lingering pain or why it affects only certain individuals remains unclear.

Summary

The specific surgical procedure Chrissy Teigen is undergoing remains undisclosed. However, in a recent Instagram Stories update on Thursday morning while she awaited her surgery, she conveyed, “Endometriosis surgery. Please endo this pain.” Irrespective of the particular surgery she’s undergoing, let’s extend our well wishes for her swift recovery and the hope that she’ll be back on her feet making her own soup in no time.