Endometriosis / Adenomyosis

If you have endometriosis, tissue normally located in the lining of the uterus grows outside the uterus. It can be found on the ovaries, fallopian tubes, bowel and possibly other places in the pelvic cavity. Sometimes it can even grow outside the pelvis.

This extra tissue may be referred to as “implants.” During your period, the extra tissue swells with blood along with the normal tissue in your uterus. This swelling and blood can irritate nearby tissues, which can cause pain or cramps. Constant irritation may cause scar tissue known as “adhesions” to form. These adhesions can bind organs together and cause additional pain or discomfort. Adhesions may also make it difficult to get pregnant or maintain a pregnancy. In other words, adhesions caused by endometriosis can cause infertility.

Endometriosis is one of the most common health problems for women.1 Symptoms are usually experienced by women in their 30s and 40s, but can occur in anyone who has menstrual periods. The exact cause of endometriosis is unknown, although there are many theories. Unfortunately, there is no cure for endometriosis but there are several treatments for the pain and infertility it may cause.

Common Symptoms of Endometriosis

If you have endometriosis, you may have one or more of these symptoms:

  • Cramps and menstrual pain
  • Pelvic pain
  • Pain during sexual intercourse
  • Infertility – trouble getting pregnant(endometriosis)

Stages of Endometriosis

The stages of endometriosis are ranked as follows: minimal (I), mild (II), moderate (III), or severe (IV). Staging of this condition depends on the number, size, and site of the implants. The stage also depends on the extent of the adhesions and whether other pelvic organs are involved. The severity of your disease may not match the pain you feel. Even mild endometriosis can cause severe pain.

da Vinci Surgery

If your doctor recommends surgery – either endometriosis resection or hysterectomy – to treat endometriosis, you may be a candidate for da Vinci Surgery. Using state-of-the-art technology, da Vinci® Surgery requires only a few tiny incisions, so you can get back to your life faster. The da Vinci System enables your doctor to operate with enhanced vision, precision, dexterity and control. da Vinci’s 3D, high-definition vision system allows surgeons to see key anatomy with immense depth and clarity– critical to removing deep endometrial tissue implants.

da Vinci Endometriosis Resection

da Vinci Endometriosis Resection allows your surgeon to perform a thorough removal of deeply penetrated or widespread endometrial implants – while preserving your uterus. Unlike conventional open and laparoscopic surgery, da Vinci Endometriosis Resectionoffers the added benefit of computer and robotic-assisted technology, with the goal of minimizing the risk of your endometriosis returning.

da Vinci Endometriosis Resectionoffers women many potential benefits over traditional laparoscopy, including:

  • Low blood loss1
  • Low conversion rate to open surgery1
  • Low rate of complications1
  • Short hospital stay1
  • Small incisions for minimal scarring

da Vinci Hysterectomy for Endometriosis – If you have decided to have a hysterectomy – removal of the uterus – you may be a candidate for da VinciHysterectomy, a definitive treatment for endometriosis. Potential benefits of da VinciHysterectomy compared to traditional open surgery include:

  • Less blood loss2
  • Fewer complications2
  • Shorter hospital stay2
  • Small incisions for minimal scarring

Potential benefits of da Vinci Hysterectomy compared to traditional laparoscopic surgery include:

  • Less blood loss3
  • Lower conversion rate to open surgery3
  • Shorter hospital stay3

The da Vinci System is a state-of-the-art surgical platform with 3D, high-definition vision and miniaturized, wristed surgical instruments designed to help doctors take surgery beyond the limits of the human hand. By helping doctors to overcome the challenges of traditional open and laparoscopic surgery, da Vinci is changing the experience of surgery for women around the world.

If you have been putting off treatment for endometriosis, it’s time to ask your doctor aboutda Vinci Surgery.

When the symptoms of endometriosis are severe or affect a woman’s quality of life, surgery is often recommended. There are two surgical options for treating endometriosis:

Endometriosis resection – This involves removal of endometrial tissue implants while leaving the uterus in place. Endometriosis resection is usually recommended for women who want to become pregnant in the future.

Hysterectomy – This procedure involves removing the uterus and other organs affected by endometriosis, such as the ovaries or fallopian tubes. Hysterectomy is often recommended for patients who do not desire a future pregnancy.

Endometriosis resection and hysterectomy can be performed with minimally invasive surgery known as laparoscopy or traditional open surgery known as laparotomy.


This is a minimally invasive procedure in which surgical instruments are inserted through small abdominal incisions to remove the implants or organ(s). One of the instruments is a laparoscope – a thin, lighted tube with a tiny camera at the end. Laparoscopy requires the use of long-handled, rigid instruments which can present limitations during complex and delicate operations that require greater precision or dexterity.


Laparotomy is traditional open surgery performed using a long abdominal incision and typically requires a long recovery. Laparotomy may be used to remove large implants that cannot be reached with a laparoscope. Laparotomy may also be recommended when pelvic organs such as your bowel are involved.

Fortunately, there is a minimally invasive option for treating endometriosis designed to overcome the limits of traditional open and laparoscopic surgery – da Vinci Surgery.

Hormone Therapy

Your doctor may recommend endometriosis be treated with over-the counter pain medications, hormone therapy, surgery, or a combination of treatments. If your pain is severe and on-going, your doctor may recommend either endometriosis resection or a hysterectomy as a cure, depending on whether you want to preserve your uterus. Talk to your doctor to find out the benefits and risks of each treatment and which one may be best for you.

Hormone therapy regulates or blocks the hormones that control your menstrual cycle. Certain hormones can limit the swelling of your endometrium and extra endometrial tissue (implants). This treatment may be used before, instead of, or after surgery. The following are different types of hormone therapies:

  • GnRH Agonists and FSH and LH Inhibitors – This medication is used to stop or lower the production of estrogen and progesterone hormones.
  • Progestins – Progestins are a form of progesterone and help to keep estrogen levels low.
  • Danazol – This hormone stops or lowers the production of estrogen and progesterone.
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