Definition and Steps of Laparoscopic Surgery

Definition and Steps of Laparoscopic Surgery

Though research into the area of non-invasive diagnosis continues, currently at this time an accurate diagnosis of Endometriosis can only be obtained surgically. Most commonly, this is done via a procedure called the laparoscopy.

What is a laparoscopy?


Laparoscopy is a Minimally Invasive Surgery (MIS) that currently provides the most accurate diagnosis of endometriosis through the least invasive surgical procedure. Laparoscopic surgery is the most advanced treatment for endometriosis, because it offers permanent removal of the endometriomas and offers the greatest pain relief. This surgery includes the excision of the endometriomas, and the scar tissue and adhesions that develop.

What happens during a laparoscopy?

A laparoscopy allows for a doctor to visualize your abdominal-pelvic region via an instrument known as a laparoscope, a thin, lighted instrument that is fitted with a telescopic lens, light sources and a miniature video camera. 

During laparoscopy, organs will be manipulated for viewing, biopsies will be taken, the diagnosis of endometriosis will be confirmed, and removal of the disease will be performed.

The surgery begins with a small (approximately ½ inch long) incision being made through the navel, into which a needle is inserted. For better visualization inside the abdominal cavity, carbon dioxide gas is injected into the abdomen through this needle. This colorless, odorless gas distends the abdominal cavity so that the organs will lift and separate to allow the laparoscope to be safely inserted. Additional similar incisions will likely be made in the pubic hairline and/or over the ovaries, through which surgical instruments can be inserted.

Once all the instruments have been strategically inserted, Dr. Seckin will begin to explore the organs and surrounding tissue, take biopsy samples, and then remove the endometriosis and adhesions. These instruments are an extension of the surgeon’s hands, so the best results are obtained when you use the most experienced surgeon.

The first step of laparoscopic surgery is diagnosing. Dr. Seckin will systematically visually evaluate each section inside the abdominal and pelvic cavity.   The peritoneum (the lining inside the body) covers the pelvis, bladder, bowel, abdominal cavity, appendix and diaphragm (bottom of the lung). It must be inspected systematically and meticulously for endometriosis, one layer at a time, so that no area is missed.

He will then take biopsies of areas that look suspicious for the disease. A pathologist than examines the tissue and gives the feedback to Dr. Seckin. Tissue is also taken and sent out for more extensive examination.

There are three basic surgical methods that are used today for treating endometriosis and they include: excision, vaporization and ablation.

Excision, which is Dr. Seckin’s method of treatment, involves cutting out the disease while preserving the healthy portions of the affected organs. Wide excision removes all of the endometriosis including the microscopic endometriosis. Studies show this is the most effective surgical means of treating endometriosis and offers the longest symptomatic relief.  

Vaporization, often referred to as the EVE Procedure™ stands for Excision and Vaporization of Endometriosis. The procedure involves the destruction of implants by instant boiling of the cellular water with a high-power laser of electrosurgical tool. This procedure is considered superficial and has a high recurrence rate. It often prevents adequate retrieval of tissue samples, due to the destructive nature of the technique. Laparoscopic helium plasma coagulation of endometriosis is another way of vaporizing endometrial deposits. Using a laparoscope, an ionized beam of helium gas is directed at endometrial deposits to destroy the affected tissue. It involves desecration of implants by heating and drying the affected tissue(s). Studies have shown, and Dr. Seckin agrees, that this method has a high recurrence rate for the disease.

Ablation of endometriosis involves burning away the surface of the lesion by using a high-energy heat source; typically, a laser. This should not be confused with the procedure known as endometrial ablation (e.g., Novasure®). Endometrial ablation is performed for the treatment of abnormally heavy bleeding, wherein the endometrium, the thin layer lining the uterus, is destroyed. This lessens or altogether stops the menstrual flow. Endometrial ablation is not a treatment for endometriosis.

Fulguration involves burning away the implants with a spark of electricity from an electrosurgical tool. Again, studies are showing that there is a high recurrence of the disease with this method. In addition to the laser and other surgical tools, some surgeons prefer ultrasonic treatment methods; this means sound waves at very high frequency will be used as the energy source.

Following the surgery


Once the surgeon is confident that all procedures have been performed and adequate samples have been taken, all instruments will be withdrawn. The abdomen is deflated and incisions closed, usually with a few dissolvable stitches covered by band-aids. Scarring is generally minor.

Our office is located on 872 Fifth Avenue New York, NY 10065.
You may call us at 212-988-1444 or have your case reviewed by clicking here.

 

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  • Angela Aro

    I have struggled with endometriosis and adenomyosis since first starting my period at 13. I was diagnosed at 21 and what followed was a series of unsuccessful surgeries and treatments. My case was very aggressive and involved my urinary tract system and my intestines. After exhausting all of my local doctors I was lucky enough to find Dr. Seckin. We…

  • Emi O

    Seckin and Dr. Goldstein changed my life!

  • Kristin Sands

    Like so many women who have tirelessly sought a correct diagnosis and proper, thorough medical treatment for endometriosis, I found myself 26 years into this unwanted journey without clear answers or help from four previous gynecological doctors and two emergency laparoscopic surgeries. I desperately wanted to avoid the ER again; a CT scan for appendicitis also revealed a likely endometrioma…

  • Wilfredo Reyes

    Dr. Seckin literally gave my wife her life back. I am eternally grateful to him for his generous, determined spirit to see that Melanie finally live free from the prison bonds of Endometriosis.

  • Carla

    I am so grateful to Dr Seckin and Dr. Goldstein. My experience was nothing short of amazing. I was misdiagnosed with the location of my fibroids and have had a history of endometriosis. Dr. Seckin was the one who accurately diagnosed me. Dr Seckin and Dr. Goldstein really care about their patients and it shows. They listened to my concerns,…

  • Melissa Boudreau

    When I think of Dr. Seckin these are the words that come to mind. Gratitude, grateful, life-changing, a heart of gold. I feel compelled to give you a bit of background so you can understand the significance of this surgery for me. I am passionate about Endometriosis because it has affected me most of my life and I have a…

  • Jaclyn Harte

    Dr. Seckin and Dr. Goldstein radically changed my quality of life. They treat their patients with dignity & respect that I've personally never seen in the literally 25+ doctors I've seen for endometriosis. This summer, I had a surgery with Dr. Seckin & Goldstein. It was my first with them, but my 5th endo surgery. I couldn't believe the difference,…

  • Megan Rafael Moreno

    I was in pain for 2 years. I was getting no answers, and because dr Goldstein and dr seckins were willing to see and treat me I'm finally feeling almost back to normal. They were very down to earth and helpful in my time of need. Dr Goldstein was easy to talk to and caring, she took care of me…

  • Nancy Costa

    Dr. Seckin is one of the best endometriosis surgeon. Every time I go to the office, he really listens to me and is always concerned about my issues. Dr Seckin's office staff are a delight and they always work with me. I feel I can leave everything to them and they will take care of it. Thank you to the…

  • Rebecca Black

    Fast forward 5 years to find out incidentally I had a failing kidney. My left kidney was only functioning at 18%. During this time, I was preparing all my documents to send to Dr. Seckin to review. However, with this new information I put everything on hold and went to a urologist. After a few months, no one could figure…

  • Monique Roberts

    I'll never stop praising Dr. Seckin and his team. He literally gave me back my life.

  • Erin Brehm

    I had a wonderful experience working with Dr. Seckin and his team before, during and after my surgery. I came to Dr. Seckin having already had laparoscopic surgery for endometriosis 5 years prior, with a different surgeon. My symptoms and pain had returned, making my life truly challenging and my menstrual cycle unbearable. Dr. Seckin was quick to validate my…

  • Anita Schillhorn

    I came to Dr. Seckin after years of dealing with endometriosis and doctors who didn't fully understand the disease. He quickly ascertained what needed to be done, laid out the options along with his recommendation and gave me the time to make the right decision for me. My surgery went without a hitch and I'm healing very well. He and…

  • Nicholette Sadé

    Dr. Seckin brought me back to life! I am now 3 weeks into my recovery after my laparoscopy surgery, and I feel like a new and improved woman! Being diagnosed with Endometriosis, then 25yrs old in 2015, and discovering the severity of my case being stage 4, made me devastated. Dr. Seckin's vast knowledge of the disease, sincere empathy, and…