Sometimes, if there are other reasons to carry out a hysterectomy it is done earlier than this. Treatment at the time of diagnosis This approach is rapidly becoming standard practice in the management of endometriosis. It is typically carried out where the endometriosis discovered is mild to moderate and the extra time required to do the surgery will be able to be accommodated within the operating list planned. A further key-hole into the abdomen is often needed. The endometriosis spots are destroyed by diathermy , where an electric current is passed down a fine probe burning the lesion.
Some surgeons use laser to evaporate the endometriosis.
Fine adhesions can be cut using small scissors. Bleeding is usually minimal and having avoided an open operation means that the risk of subsequent adhesion development is reduced. Laparoscopic managment also has the advantage of needing a minimal hospital stay, it is usually possible to go home the same or following day. There has been only one good quality study of the effect of surgical treatment of mild to moderate endometriosis on subfertility. Moderate to severe disease Where endometriosis is more than a few spots, and in particular where there is more severe scarring or an ovarian endometrioma, there is still the option of laparoscopic treatment in some hospitals.