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Anyone had removal of endometrioma via laparoscopy? (post hysterectomy?) Anyone had removal of endometrioma via laparoscopy? (post hysterectomy?)

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Unread 08-27-2004, 01:26 AM
Anyone had removal of endometrioma via laparoscopy? (post hysterectomy?)

I was wondering if anyone out there has had an endometrioma or other type of cyst removed successfully via laparoscopic surgery? I had many laparotomies and laparoscopies in my 20s to remove cysts, adhesions, hysterectomy, right ovary, and most of the left ovary (could not remove all as it was stuck on the colon). Anyway, I have just been diagnosed with an endometrioma and the gyne is confident she can remove it using a scope rather than opening me up and fix up any other problems at the same time. This was fantastic news as the recovery period would obviously be much shorter and less painful, but my referring MD is concerned. He thinks because of all the scar tissue and adhesions from previous surgery, open surgery would be safer. I realize techniques have advanced significantly since my last surgery and wondered if others have had good experiences having cysts removed using laparoscopy? I don't understand how the scope can remove it without spilling the contents inside and spreading more endo. How do they actually do it? I want to trust my specialist completely but my doctor has got me having second thoughts. I would love to hear from those of you with similar experiences.

I am new to this wonderful site and have already found much support.

PS sorry I haven't figured out all the right abbrievations just yet!
PPS I also posted this in the wrong place the first time and thanks aussieone for letting me know
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Unread 08-27-2004, 01:52 AM
Hi again Helen......

The lap people are amazing with what they can do these days. But if there is any doubt about whether it is malignant or not, then they will do the wider incision.

When will your procedure be done? I too had endo in my twenties and am now 48. Getting a little tired of it all now. Lets keep in touch with each other - I have a surgeon appointment on Monday so will know more then.

Unread 08-27-2004, 02:02 AM
Answer to Aussieone re: endometrioma

It is tentatively being done at the end of September as the gyne wanted me to have other tests after I saw him this week - IVP xray, CA125 and a colonoscopy. The docs seem sure it is an endometrioma. I need to see a colerectal surgeon as I've had a lot of partial bowel obstructions since all the previous surgery so I guess they need to be sure they know what they are dealing with before they go in. I had a colonoscopy two years ago because of all this pain but they couldn't get the scope round although what they saw looked good inside. Anyway, once I get through that lot and have the results we can go ahead. I just want it over and done with now. I was pretty concerned about the need for a CA125 - the gyne explained that women with an endometrioma are more at risk - have you heard that? I really don't understand how all this can have developed so long after everything was taken out!!!

I had no idea they could remove something so large! How do they actually do it? Thank you so much for sharing this - I feel much more reassured now about removing this thing via scope :-)

How long have your had yours? Have you already had a hysterectomy? Do you still have your ovaries? I really hope everything goes well for you. When are you scheduled?
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Unread 08-27-2004, 02:41 AM

I had a CA125 test - my score was 14 which is OK but I have been doing heaps of research and know that: CA125 can be raised with ovca, but also endo, menstruation, infection, etc etc. So it is just not reliable. It can also be low when you have early stage cancer! It seems to be most useful when you have actually been diagnosed with Cancer, and they can monitor it falling with surgery and treatment.

I am still all in tact, but I also have fibroids, polyps, endo and this complex cyst. I constantly spot dark blood, but a Mirena IUD has stopped my periods. I am still really active in my ovaries as all the sonos show many follicular cysts each month. They hurt heaps!

It wouldnt surprise me if I end up with a complete hyster after Monday but time will tell. I hope to at least get rid of the cyst n mid September.

In the surgery, they usually bag the ovary and remove it either thru the incision or the vagina if no uterus. I guess if people can give birth then they can do this! I know, its amazing what they can do.

I'll post again on Monday after the appointment - it is a 2 hour one with a Lap specialist, so I will be asking heaps of questions - but most of all I just dont what this cyst to rupture in my tummy so will definiately want my ovary and not just the cyst, removed.
Unread 08-27-2004, 08:03 AM
Anyone had removal of endometrioma via laparoscopy? (post hysterectomy?)

If it were me, I'd make another appointment with the gyn/surgeon who is proposing the surgery and ask any remaining questions. If you are still concerned, seek a second opinion from another gyn/surgeon.

I know it is common to remove gallbladder laparoscopically now days, so I imagine however they manage that is how they would remove the endometrioma. But, I'm not a doctor and you really should ask yours more questions.

Lots of s for you, dear, as you sort through this.
Unread 08-27-2004, 09:40 PM
Anyone had removal of endometrioma via laparoscopy? (post hysterectomy?)

I'd ask for referral to a GYN-oncologist. They have more surgical experience and training with complex cases -- including the experience and training to do bowel repairs, if needed.

I'm with you in the concern that rupturing an endometrioma would "seed" endo. Another good reason for having an oncologist do this next surgery is that if, heaven forbid, this turns out to be something other than endometrioma -- well, the outcomes are considerably better in the hands of the oncologists.

I had my surgery for endometrioma; now I'm considering adhesion exploration and am concerned that it may not be possible or reasonable done laparoscopically. If your surgeon has done very large numbers of these, maybe -- but if there is any question of malignancy, you need the oncologists.

-- good luck with it all!


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