Like millions of other women who have endometriosis, Mary has traveled a long and sometimes arduous journey. Coping with the disease can be frustrating, seemingly without end, but Mary has found that there is hope. Through new medical procedures, new research, and a greater understanding of endometriosis, Mary has found there are choices. Two years ago I had major surgery to remove endometriosis from my fallopian tubes, ovaries, and uterus. I knew even then that the surgery would not cure my disease, but I kept hoping that somehow it was gone. In the past three months my symptoms returned, they were all too familiar. I didn't want to endure another major surgery, but I had already tried most of the other medical options. It was a very frustrating period of my life. I was fortunate, however, when I found a physician who really understood endometriosis and the latest treatment options. It's good to see you again, Mary. I have some good news and some bad news. The bad news is that as you suspected, your endometriosis has probably returned because I can feel the nodules. Now the good news is that this time, should you choose surgical treatment, you won't have to undergo another major surgery. Instead, we can now do the surgery through the laparoscope. I thought we used a laparoscope to diagnose my endometriosis. You're exactly right, Mary, but since then several new procedures have been developed that actually allow us to perform the surgery through the laparoscope. As you know, the laparoscope is nothing more than a long, thin telescopic device that is inserted in the abdomen through a small incision. Through this device, we look for the presence of endometriosis, which is, of course, implants, adhesions, and scar tissue that have formed outside the uterus. The first method of surgically removing endometriosis through the laparoscope is by using traditional surgical tools to mechanically remove the disease. These tools dissect and remove the endometriosis by cutting and removing the growths, just as is done during major surgery, but without the complications of major surgery. The second method involves the use of electrical current to burn and destroy the endometriosis. It's called electrosurgery and can be done with a variety of electrosurgical tools. Electrosurgery is not as confusing as it may sound. It simply involves using special electrical instruments introduced through the laparoscope to destroy the endometriosis and adhesions. Now, in addition to mechanical and electrosurgical approaches, another technique for surgically destroying endometriosis has been developed by a group of German physicians. It's called endocoagulation. This procedure is also performed during operative laparoscopy. The last approach is the one that's become most popular. This treatment uses a laser through the laparoscope. Laser surgery? Why do you want to do laser surgery? That sounds like science fiction. Actually laser surgery is not science fiction at all. It's been used successfully for years in many surgical procedures, but it is a relatively new treatment for endometriosis. Laser laparoscopy is actually quite easy to understand. The word laser stands for light amplification by the stimulated emission of radiation. In the simplest terms, it's a powerful concentration of energy capable of being focused to a pinpoint. It can very precisely vaporize or cut diseased tissue while leaving healthy tissue intact. Lasers can also be used to coagulate or stop bleeding during surgery. These features are of special importance to the treatment of endometriosis, which can be extremely difficult to remove from sensitive organs such as the ovaries, fallopian tubes, bladder and bowel. As you know, Mary, complete removal of the endometriosis is important to give you the best chance for lasting relief from the disease. By combining the power and the precision of the laser, the less invasive technique of the laparoscope, laser laparoscopy facilitates this removal even in the most difficult locations. I'd like for you to read this information on laser laparoscopy. If you have any questions after you look it over, give my office a call. And if it seems like this is the way you would like to go, give me a call and we'll sit down and discuss it further. I was impressed. According to the literature, the laser surgery would be done on an outpatient basis. And when I spoke with my doctor the second time, I was told I would probably go home the night after surgery. I did a lot of research before I made my decision. And one of the things I discovered is that women who undergo laparoscopic surgery are often under anesthesia for a shorter period of time than those who have major surgery. That's one of the reasons laparoscopic surgery costs less money. Laparoscopic surgery also reduces the risk of adhesions. I also found out that the results of pregnancies and the relief of pain after laparoscopic surgery is quite good. The biggest revelation for me, however, was at a local support group. I spoke with several women who have had laparoscopic surgery and major surgery, and they all talked about how much easier it was to recover from the laparoscopic procedure. They experienced considerably less pain and were able to resume their activities much more quickly. That's what made up my mind. The morning of my laser laparoscopy, my husband Jim and I drove to the surgery center. Following my physician's advice, I had nothing to eat or drink since the night before. Jim stayed with me as I checked in and was taken to a room to be prepared for the procedures. We listened together as the anesthesiologist discussed the general anesthetic that was used to keep me comfortable. Of course, I was not conscious during the surgery and had no recollection of it. Members of the surgical team routinely include the surgeon, anesthesiologist, surgical technician, and circulating nurse. Instruments commonly used during laser surgery include the laparoscope, which is outfitted with a light and video camera, the laser, tiny forceps, and an irrigator. During the surgery, two or three small incisions are made in the abdomen. Through these incisions, the laser and other instruments are introduced. The video camera is used to project an image of the internal organs on a high-resolution monitor. This gives the entire surgical team a clear, unrestricted view of the procedure. In Mary's case, the actual surgery progressed quickly. The implants and adhesions caused by her endometriosis were quickly cut or vaporized with the laser. After only an hour, the surgeon removed the laparoscope and closed the incisions with tiny sutures. Mary was taken to the recovery room for a few hours, and then she was sent home to recuperate. It's only been four weeks since my laser surgery, and I feel great. After my major surgery, I was out of work for five weeks, but this time I was back in five days. There has been such a difference in my recovery this time. I want every woman who suffers from endometriosis to know that laparoscopic surgery is available, and she should insist on discussing it with her physician. No matter what type of laparoscopic surgery her physician wants to perform, it will be easier on her than open abdominal surgery. I know my endometriosis is not cured. I know that even with laser surgery, it will probably come back. But I also know that it might take longer to reoccur, and if it does, I can recover much faster from a laparoscopic procedure than from major surgery. Dealing with my endometriosis has been difficult, but now I know there are choices. I'm glad I took the time to find out about them. After all, it's my body.