Laparoscopic Surgery for Endometriosis & Chocolate Cysts: Procedure, Recovery & Cost in Mumbai

If left untreated, endometriosis can result in severe complications, including:

• Chronic pelvic pain
• painful periods   ( dysmenorrhea ); pain may be debilitating often restricting the daily activities  
• painful sexual intercourse  ( dyspareunia )
• chronic pelvic pain
• Kidney, bowel, or nerve damage
• Adhesions that cause organs to stick together
• While medications may offer relief, surgical intervention is often required for long-term management.
• infertility

Laparoscopy is the preferred surgical method for treating endometriosis and chocolate cysts due to its minimally invasive nature. This technique provides:

• High precision with magnified visualization
• Shorter hospital stay and early resumption of daily activity
• Better cosmetic appearance as its done through small cuts only. 
• Reduced pain compared to open surgery
• Improved fertility outcomes for women trying to conceive

Laparoscopic surgery for endometriosis involves inserting a  fiber-optic laparoscope attached to a camera through a small incision in the abdomen. This allows the surgeon to see the inside of the abdomen on a larger screen with magnification.  It s useful to :

• Identify and remove endometriotic lesions 
• Excise nodules and adhesions
• Restore normal pelvic anatomy 

This method ensures accurate treatment with minimal damage to surrounding tissues.

Chocolate cysts (ovarian endometriomas) can be effectively treated using laparoscopy. The procedure includes:

• Small incision near the belly button for laparoscope insertion
• Drainage of cyst contents to relieve pain and discomfort
• Excision of cyst walls to reduce recurrence risk
• Simultaneous treatment of adhesions or other related conditions
• Indications for Laparoscopic Surgery
• Laparoscopic surgery may be recommended if you experience:
• Severe menstrual pain (dysmenorrhea)
• Pain during sexual intercourse
• Infertility
• Chronic pelvic pain due to adhesions
• Risk of kidney, bowel, or nerve damage

Types of Laparoscopic Procedures are as follow:

• Fulguration of Endometrial Implants: Superficial implants are burned using controlled electrical energy.
• Excision of Implants ; Nodules and affected tissues : Deeper implants and nodules are removed completely.
• Excision of Chocolate Cysts: Cysts are drained, and their walls are removed to prevent recurrence.
• Adhesiolysis: Adhesions causing organ dysfunction are carefully cut to restore normal function.

Before undergoing laparoscopic surgery, patients should:

• Bring all necessary medical reports, including blood tests and imaging
• Follow a light diet the day before surgery
• Avoid dairy and heavy meals before the procedure
• Discontinue medications like estrogen or blood thinners as advised
• Continue essential medications for thyroid, blood pressure, or diabetes
• Take prescribed bowel-cleansing solutions for a smoother procedure
• The Laparoscopic Procedure
• Performed under general anesthesia
• A small incision is made near the belly button
• The abdomen is inflated with CO2 gas to improve visibility
• A laparoscope is inserted to assess and treat the condition
• Additional  3 to 4 tiny incisions are made to insert surgical instruments
• Endometriosis implants, nodules, adhesions, and chocolate cysts are carefully removed

• Patients are monitored for about 2 hours post-surgery
• Mild shoulder or back pain due to CO2 gas may occur but resolves quickly
• Fatigue and slight discomfort are normal but improve with time
• Patients should contact their doctor immediately if they experience persistent pain, nausea, vomiting, excessive bleeding; or unusual symptoms

Laparoscopic surgery for endometriosis and chocolate cysts is a minimally invasive procedure that offers faster healing and less discomfort compared to traditional open surgery. Understanding the recovery process is crucial for a smooth and successful healing journey

1. Immediate Post-Surgery Care

• You may feel sleepy due to anesthesia.
• Mild to moderate pain, bloating, and shoulder pain (from the gas used during surgery) are common.
• after 5 to 6hours you may be allowed to have sips of water followed by light diet.
• You may be encouraged to walk around after 5 to 6hours . early ambulation means speedy recovery.
• Some spotting or light bleeding is normal.

Most patients can go home the same day or within 24 hours. while those who have undergone extensive DIE surgery; may be kept admitted in the hospital for 3 to 4 days. 

2. First Few Days of Recovery

• Rest is essential; avoid strenuous activities. However slow movements are always  encouraged.
• Take prescribed  antibiotics  and pain killers as directed.
• Stay hydrated and eat a light, nutritious diet which has to be full of roughage .
• Walk gently to improve blood circulation and prevent blood clots.
• Avoid lifting heavy objects and   excessive forward bending  .

3. One to Two Weeks Post-Surgery

• Most patients feel better within a week but should still avoid vigorous physical activities.
• Follow-up  visits are required to monitor healing progress.
• Any persistent pain, fever, bleed og r unusual discharge should be reported to your doctor.

4. Full Recovery Timeline

• Most women resume light work within 7-10 days.
• Complete internal healing may take 6-8** weeks**.
• Resumption of physical activities, including exercise, should be started as advised by your doctor. .
•  if you experience any of the following, seek medical attention immediately:
• Severe abdominal pain that doesn’t improve
• Heavy bleeding or foul-smelling discharge
• High fever or chills
• abdominal distension
• difficulty urinating or passing stool

Long-Term Outlook

Laparoscopic surgery for endometriosis and chocolate cysts significantly reduces pain and improves fertility outcomes in many cases. However, follow-up care and lifestyle changes may be necessary to prevent recurrence.

For personalized guidance and post-surgery support, consult your gynecologist or surgeon. If you’re considering laparoscopic surgery, contact us today to schedule an appointment!

At Vardaan Hospital, Goregaon West, Mumbai, Dr. Dimple Doshi offers expert laparoscopic surgery for endometriosis and chocolate cysts. Patients can choose from a range of room options:

Book Your Consultation

Take control of your health today. For more information or to schedule a consultation, contact Dr. Dimple Doshi at Vardaan Hospital. Get expert care and advanced surgical solutions for endometriosis and chocolate cysts in Mumbai.

Q1. What is the best treatment for chocolate cysts?

Ans. The best treatment depends on the size of the cyst, symptoms, and your future pregnancy plans. For smaller cysts, doctors may recommend pain relief medications or hormone therapy (like birth control pills) to manage symptoms. Larger or painful cysts might require surgery, usually laparoscopic, to remove the cyst while preserving the ovary.

Q2. Are chocolate cysts related to endometriosis?

Ans. Yes, chocolate cysts — also called ovarian endometriomas — are a type of cyst caused by endometriosis. They form when endometrial tissue grows inside the ovaries, fills with blood, and turns dark brown (like melted chocolate). They’re a sign of more severe endometriosis and can affect fertility.

Q3. What is the surgery for chocolate cysts called?

Ans. The surgery to remove chocolate cysts is called a laparoscopic cystectomy. It’s a minimally invasive procedure where small incisions are made to access and remove the cyst, helping relieve pain and improve fertility outcomes.

Q4. Can an endometrioma be removed laparoscopically?

Ans. Yes! Laparoscopic surgery is the most common and effective way to remove an endometrioma. It’s a less invasive procedure with smaller incisions, faster recovery, and less scarring compared to open surgery.

Q5. What happens if a chocolate cyst is not removed?

Ans. If left untreated, a chocolate cyst can grow larger, cause severe pelvic pain, disrupt your menstrual cycle, and even damage the ovary. In some cases, the cyst might rupture, causing sudden, intense pain and needing emergency care.

Q6. What size endometriotic cyst requires surgery?

Ans. Generally, cysts larger than 4-5 cm that cause pain, impact fertility, or keep growing despite medication may need surgical removal. Your doctor will consider your symptoms and overall health to decide the best approach.

Q7. Is laparoscopic surgery safe for endometriosis?

Ans. Yes, laparoscopic surgery is considered safe and is often the preferred method for treating endometriosis. It helps remove lesions, cysts, and scar tissue with minimal impact on surrounding organs. Recovery is typically quicker than with open surgery.

Q8. Can a 7 cm cyst be removed laparoscopically?

Ans. Yes, a 7 cm cyst can usually be removed laparoscopically, though it depends on its location and complexity. Surgeons are often able to remove larger cysts through small incisions, preserving ovarian tissue whenever possible.

Q9. At what size should an endometrioma be removed?

Ans. Typically, an endometrioma larger than 4 cm may be considered for removal, especially if it causes severe pain, interferes with fertility, or grows over time. Even smaller cysts might need surgery if symptoms are difficult to manage with medications.