Why are doctors ramping up laparoscopic surgeries for endometriosis without encouraging proper post-op scar healing?
It’s 2022. We are seeing more and more infertility, more diagnoses of endometriosis, more gut troubles. Our baseline is a disease state. We are thankfully seeing more doctors becoming aware of endometriosis, how common it is, and being more willing to diagnose it. Whether it’s the ‘stabbing pain’ during menses, or whether it’s simply difficulty getting pregnant, more fertility doctors and OB/GYN specialists are recognizing the scourge this disease is having on women and uteruses in our community. THIS is a good thing. A movement away from dismissing symptoms as “normal menstruation", or “just gas” or, the worst— “STRESS.” The good news is that we have momentum, more knowledge, and tools for treating endometriosis. The bad news is the surgery to help heal can also cause secondary harm.
Right now, the gold standard of endometriosis treatment is laparoscopic surgery to explore the outside of the abdominal and pelvic organs and structures, and excise (cut out) any endometriosis lesions. In the grand scheme of surgeries, this one is relatively less invasive, but it’s still surgery that requires highly skilled clinicians, anesthetic drugs, pumping in carbon dioxide to the abdomen, and incisions. It’s still surgery that requires extensive recovery time and healing.
Laparoscopic surgery for endometriosis requires manual therapy as part of recovery to address the scar tissue. Scar tissue can arise from the abdominal incisions, there can be oxidation from having the internal body be open to the external environment and air, and there can be scarring that arises from the places of endo lesion excision. This scar tissue can lay down in a chaotic pattern, creating a network of fibrous, immobile tissue. It can even cause adhesions between abdominal structures that the surgery was seeking to undo- just now instead of endometriosis causing the adhesion, it’s the scar tissue afterward causing the adhesion.
Manual therapy like massage, deep visceral manipulation, and Mercier Therapy should be a non-negotiable prescription after endometriosis surgery.
Starting around 6 weeks post-op is when you can start to gently reconnect with the scars, and the tissues beneath. A therapist can help break down the scar tissue that has formed, making it more pliable, more vital, and more connected with the greater pelvic and abdominal environment.
Laparoscopic surgery temporarily removes endo from the abdomen, but for many people, the disease can come back with a vengeance- weeks, months, or years after excision. Manual massage and Mercier Therapy can help keep someone symptom-free by reducing restrictions, keeping organs moving, and receiving good blood flow— even if lesions have developed again.
So, why are doctors signing people up for endometriosis surgery, then leaving them in the dust in post-op? It’s not malicious, it’s usually just too many clients, too little knowledge, and a poor list of care providers outside the medical field.
If you are getting surgery for endometriosis, do yourself a favor and line up a practitioner who can work with you once you’ve healed. Someone who can teach you self care techniques, and someone who can work deeply and respectfully with your healing tissues.
Looking for more information about endometriosis? Check out Nancy’s Nook, a great resource with plenty of compiled information and referrals.