Usually a minor surgical procedure, called laparoscopy, is performed under general anesthesia for this purpose. A small lighted instrument is inserted through the navel, and the surgeon looks through the instrument directly or, with the aid of a camera attached to the laparoscope, the pelvis can be projected on a TV screen. The incision in the abdomen ranges from approximately two to five inches in length. This abdominal surgery may be needed when a large endometrioma has been identified by the sonogram or if a pelvic mass of uncertain cause is found on examination. In addition, endometriosis may be incidentally found during an abdominal surgery performed for another reason, such as fibroids, an ovarian cyst or even surgery for appendicitis.
Treatment is divided into three paths - observation, medication, or surgery.
Women who have minimal or mild endometriosis and do not have pain may not require any treatment other than careful follow-up. In practice, however, if the diagnosis of endometriosis is made during laparoscopy, most gynecologists will burn or cut away these cells. However, a few studies have demonstrated that this treatment of mild endometriosis does not enhance fertility. For women with mild endometriosis, fertility rates are good even if no treatment is performed. It is known that estrogen causes endometriosis to grow.