Description

Endometriosis is a common gynecological condition where tissue similar to the lining of the uterus grows outside the uterine cavity, causing pelvic pain, dysmenorrhea, and sometimes infertility. Mild endometriosis, classified as Stage I or II by the American Society for Reproductive Medicine (ASRM), often involves superficial lesions on the peritoneum, ovaries, or pelvic structures. Laparoscopic fulguration is a minimally invasive surgical technique widely used for the treatment of mild endometriosis. It involves the destruction of endometrial implants using energy sources such as monopolar or bipolar electrosurgery, laser, or other advanced energy devices. This procedure is performed under general anesthesia using laparoscopic instruments, allowing precise removal or ablation of endometriotic lesions while preserving surrounding healthy tissue. Procedure Overview: Preoperative Preparation: Patients undergo imaging and hormonal evaluation. Laparoscopy is preferred when medical therapy has not adequately relieved symptoms or when infertility is a concern. Diagnostic Laparoscopy: A small camera is inserted through the abdominal wall to visualize the pelvic organs. Lesions are identified based on characteristic appearance—dark, red, or powder-burn lesions on the peritoneum or ovaries. Fulguration of Lesions: Once identified, endometriotic implants are destroyed using a controlled energy source. Care is taken to minimize damage to surrounding structures, such as the bowel, bladder, and blood vessels. Postoperative Care: Patients usually recover quickly due to the minimally invasive nature of the procedure. Pain relief, early mobilization, and hormonal therapy may be advised to prevent recurrence. Benefits of Laparoscopic Fulgration: Minimally invasive: Reduced postoperative pain and faster recovery compared to open surgery. Symptom relief: Effective in reducing pelvic pain and dysmenorrhea. Fertility improvement: Removal of superficial lesions can improve reproductive outcomes in women with infertility. Precise and targeted: Lesions can be ablated with minimal impact on healthy tissue. Limitations: Recurrence is possible, especially if deep infiltrating endometriosis is missed. Effectiveness may vary, and some patients may require medical therapy postoperatively. Skill-dependent procedure requiring experienced laparoscopic surgeons. Conclusion: Laparoscopic fulguration remains a cornerstone in the management of mild endometriosis. It offers effective pain relief, preserves fertility, and allows a quick recovery. When combined with appropriate postoperative care and hormonal therapy, it significantly improves the quality of life for women suffering from this condition.