Endometriosis Surgery: Types, Recovery, Risks, and Results
Updated: 6 days ago
Written and medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026 · How we review
Quick Answer: What is endometriosis surgery?
Endometriosis surgery is an operation that diagnoses and treats endometriosis, a condition in which tissue that normally grows inside the uterus grows outside it. Most people have laparoscopy, a minimally invasive procedure through small incisions, and go home the same day. Normal routines usually return in about two weeks; open surgery needs several weeks. [1]
What the research says
Surgery may ease pain more than a look-only procedure. A systematic review of randomized trials found that operative laparoscopy improved overall pain at 6 months compared with diagnostic laparoscopy alone (risk ratio 2.65; 2 trials, 102 participants; low-quality evidence). (Leonardi et al., J Minim Invasive Gynecol, 2020)
Removing endometriosis probably improves pregnancy rates. In a review of 14 trials with 1,563 women, laparoscopic treatment probably increased viable intrauterine pregnancy rates compared with diagnostic laparoscopy only (odds ratio 1.89; 3 trials, 528 participants; moderate-quality evidence). (Bafort et al., Cochrane Database Syst Rev, 2020)
About 1 in 10 people have another operation. A 2026 meta-analysis of 57 studies (22,644 patients) found a pooled reoperation rate of 10.81% after minimally invasive endometriosis surgery — 4.40% with hormonal treatment after surgery versus 11.23% without. (Lemos et al., J Minim Invasive Gynecol, 2026)
Key takeaways
Laparoscopy is the most common type of endometriosis surgery and needs only small incisions. [1]
Open surgery (laparotomy) is used less often, mainly for severe disease or when laparoscopy isn't possible. [1]
Most people feel significant pain relief, but about 20% don't respond and need further treatment. [1]
Endometriosis can come back, especially if lesions aren't fully removed or the ovaries aren't suppressed afterward. [1]
A fever of 101°F (38.3°C) or higher, heavy vaginal bleeding, or worsening pain after surgery needs a call to your provider. [1]
What is endometriosis surgery?
Endometriosis surgery is a procedure used to both diagnose and treat endometriosis. [1]
Endometriosis is a condition in which tissue that typically grows inside the uterus grows outside of it instead. Surgery removes these areas of tissue. [1]
Is endometriosis surgery a major surgery?
In most cases, endometriosis surgery is not a major surgery. [1]
In the past, surgeons used open surgery with a large cut across the abdomen. Today, almost everyone who needs this operation can have laparoscopy instead, which only requires small incisions. [1]
What are the types of endometriosis surgery?
The two types of endometriosis surgery are laparoscopy and laparotomy. [1]
Feature | Laparoscopy | Laparotomy |
Type of surgery | Minimally invasive | Open surgery |
Incisions | One or a few small incisions | One large incision across the abdomen |
How often it's used | Most common approach | Used less often than in the past |
Who it suits | Mild to severe cases, done by surgeons trained in the method | Severe disease, or people who don't qualify for laparoscopy |
Hospital stay | Usually home the same day | Longer, more invasive procedure |
Recovery | Normal routines in about 2 weeks | Usually several weeks |
Laparoscopy
Laparoscopy is the most common approach to endometriosis surgery. [1]
The surgeon makes a small incision in your abdomen and inserts a laparoscope — a thin tube with a camera — through it. Some people need more than one small incision. [1]
Laparotomy
Laparotomy is an open surgery that is more invasive than laparoscopy. [1]
It uses one large incision across the abdomen instead of a few small ones. Your surgeon may choose it when your condition is severe or when you don't qualify for laparoscopy. [1]
Is laparoscopy better than laparotomy for endometriosis?
Laparoscopy is considered superior to laparotomy because it causes fewer surgical complications. [1]
Compared with open surgery, laparoscopy carries a lower risk of:
Bleeding
Infection
Injury to other organs in the abdomen
It also offers a faster recovery and less downtime. [1]
Who needs endometriosis surgery?
Endometriosis surgery may help people whose symptoms are severe, long-lasting, or no longer controlled by medicine. [1]
A healthcare provider decides whether surgery is right for you. It may be beneficial if: [1]
You have chronic (long-standing) or severe pelvic pain.
Areas of endometriosis in your pelvis need to be removed.
Medication no longer relieves your symptoms.
You have difficulty getting pregnant.
How do you prepare for endometriosis surgery?
You prepare for endometriosis surgery by following the specific instructions your healthcare provider gives you. [1]
General steps include: [1]
Before surgery | Why it matters |
Arrange a trusted friend or family member to drive you | You won't be able to drive yourself home |
Don't eat or drink after midnight the night before | Required before general anesthesia |
Ask whether to stop any medicines, such as blood thinners | Some medicines affect surgery |
Quit smoking at least 3 weeks before surgery | Supports a safer procedure |
Stock up on fluids and light foods, such as soup and gelatin | Makes the first days at home easier |
What happens during laparoscopic endometriosis surgery?
During laparoscopic endometriosis surgery, a surgeon uses a camera passed through a small incision to find and remove endometriosis while you're under general anesthesia. [1]
The procedure follows these steps: [1]
An anesthesiologist places you under general anesthesia and monitors your vital signs.
The surgeon makes a small incision in your bellybutton or another part of your abdomen. Sometimes more than one incision is needed.
Gas is used to inflate your belly so the laparoscope has a clear view.
The surgeon inserts the laparoscope through the incision.
The laparoscope is used to find areas of endometriosis.
Special instruments attached to the laparoscope remove the affected tissue.
The laparoscope and instruments are removed.
The incisions are closed with stitches.
How long does it take to recover from endometriosis surgery?
Most people return to normal routines about two weeks after laparoscopic endometriosis surgery, though some need longer. [1]
After laparoscopy, you rest in a recovery area until your medical team clears you, and you'll probably go home the same day. Feeling tired for a few days is common. [1]
Situation | Typical recovery |
Laparoscopy | Home the same day; normal routines in about 2 weeks |
Mild endometriosis | May heal more quickly |
Laparotomy (open surgery) | Usually several weeks |
Advanced endometriosis | 6 weeks or longer |
Your healthcare provider will give you detailed instructions to follow after surgery. [1]
When can you go back to work or school after endometriosis surgery?
Most people can go back to work or school about two weeks after endometriosis surgery, unless their job is physically demanding. [1]
If your work involves a lot of physical activity, you may need to wait longer. Ask your healthcare provider what to expect for your own recovery. [1]
Does endometriosis surgery relieve pain?
Most people notice significant pain relief after endometriosis is removed. [1]
However, about 20% of people who have surgery don't respond and need further medical treatment. Among those who do respond, pain may return over time. [1]
Can endometriosis come back after surgery?
Endometriosis can come back after surgery, even though surgery usually relieves pain. [1]
Whether it returns depends on three factors: [1]
Factor | What it means |
Severity at surgery | How severe the disease was at the time of the operation |
Completeness of removal | How completely the surgery removed the lesions |
Treatment after surgery | Whether you received medical suppressive therapy afterward |
Hormones made by the ovaries stimulate endometriosis. To control it, your provider may recommend medicine that suppresses the ovaries, such as birth control pills or progesterone-only medicines. [1]
How quickly can endometriosis grow back?
Endometriosis can grow back soon after surgery if the disease isn't completely removed or if the ovaries aren't suppressed. [1]
Lesions found after surgery may be new or may have been there before. This makes it hard to tell whether the disease has come back or is progressing. [1]
What are the risks of endometriosis surgery?
Endometriosis surgery is relatively safe, but like any procedure it carries possible complications. [1]
Possible complication | What it is |
Infection | Germs entering the surgical area |
Bleeding | Blood loss during or after surgery |
Organ injury | Possible injury to nearby organs, such as the bladder or bowel |
Fistula | An abnormal connection between two organs |
Blood vessel damage | Injury to blood vessels near the surgical area |
Does endometriosis surgery help fertility?
In many cases, endometriosis surgery can improve your chances of getting pregnant naturally. [1]
If you don't become pregnant within a reasonable time after the procedure, having surgery again probably won't help. Treating early-stage endometriosis to improve fertility is also controversial. [1]
If you're trying to conceive, talk with a healthcare provider about personalized treatment. You can also read our guide to female infertility and the patient fact sheet from the American Society for Reproductive Medicine.
When should you call a doctor after endometriosis surgery?
Call your healthcare provider after endometriosis surgery if you notice signs of infection, heavy bleeding, or pain that keeps getting worse. [1]
Contact your provider if you have: [1]
Redness or swelling around the incision sites
A fever of 101°F (38.3°C) or higher
Pain that worsens or doesn't improve with medicine
Pus draining from an incision
Heavy bleeding from your vagina
A feeling that you can't empty your bladder
What is the outlook after endometriosis surgery?
Many people find success with medication and surgery, but these treatments have side effects and don't work for everyone. [1]
Researchers continue to study new and better treatments. One area of research focuses on the role of the immune system in how endometriosis develops. [1]
Conclusion
Endometriosis surgery is usually a minimally invasive laparoscopy that lets most people go home the same day and return to daily life in about two weeks. It brings significant pain relief for most people and may improve the chances of natural pregnancy. Endometriosis can return, so follow-up care and, when advised, medicine to suppress the ovaries matter as much as the operation itself.
Your next step: If pelvic pain, painful periods, or trouble getting pregnant are affecting your life, book a visit with your healthcare provider and ask whether endometriosis surgery fits your situation. Bring this guide as a checklist of questions. To understand the condition itself, start with our full guide to endometriosis symptoms, causes, and treatment, then read about retrograde menstruation and adenomyosis. For more patient information, see the American College of Obstetricians and Gynecologists endometriosis FAQ.
FAQ
Is endometriosis surgery a major surgery?
In most cases, no. Almost everyone who needs endometriosis surgery can have laparoscopy, a minimally invasive procedure that uses only small incisions. Open surgery with a large incision is now used much less often.
How long does it take to recover from endometriosis surgery?
Most people return to normal routines about two weeks after laparoscopy. Advanced endometriosis can take six weeks or longer, and open surgery usually needs several weeks. People with mild endometriosis may heal more quickly.
When can I go back to work after endometriosis surgery?
Most people can go back to work or school about two weeks after surgery. If your job is physically demanding, you may need to wait longer, so ask your provider what to expect.
Can endometriosis come back after surgery?
Yes, endometriosis can come back after surgery. The risk depends on how severe the disease was, how completely the lesions were removed, and whether you take medicine to suppress the ovaries afterward.
Does endometriosis surgery help you get pregnant?
In many cases, endometriosis surgery can improve your chances of getting pregnant naturally. If pregnancy doesn't happen within a reasonable time after the procedure, a second surgery probably won't help.
Will I need medicine after endometriosis surgery?
Your provider may recommend medicine after surgery to keep endometriosis under control. Birth control pills or progesterone-only medicines can suppress the ovaries, whose hormones stimulate endometriosis.
What are the risks of endometriosis surgery?
Endometriosis surgery is relatively safe. Possible complications include infection, bleeding, injury to nearby organs such as the bladder or bowel, a fistula, and blood vessel damage.
When should I call my doctor after endometriosis surgery?
Call your provider if you have a fever of 101°F (38.3°C) or higher, redness, swelling, or pus at an incision, heavy vaginal bleeding, worsening pain, or trouble emptying your bladder.
How is endometriosis diagnosed?
Doctors often suspect endometriosis from your symptoms, a pelvic exam and imaging such as an ultrasound. Laparoscopy with a tissue sample can confirm it and treat it at the same time.
What is the difference between excision and ablation of endometriosis?
Excision cuts out the endometriosis tissue, while ablation destroys it on the surface with heat or energy. Your surgeon chooses the method based on how deep and where the tissue is.
Related Reading
Endometriosis Ultrasound: What It Can Find, What It Misses, Preparation and Results explains the specialized transvaginal scan that maps endometriomas and deep nodules.
References
Cleveland Clinic. Endometriosis Surgery: Procedures, Recovery & Results. Cleveland Clinic. Last updated September 13, 2022. https://my.clevelandclinic.org/health/treatments/4620-endometriosis-surgery
Leonardi M, Gibbons T, Armour M, et al. When to do surgery and when not to do surgery for endometriosis: a systematic review and meta-analysis. J Minim Invasive Gynecol. 2020;27(2):390-407.e3. PMID: 31676397. https://doi.org/10.1016/j.jmig.2019.10.014
Bafort C, Beebeejaun Y, Tomassetti C, et al. Laparoscopic surgery for endometriosis. Cochrane Database Syst Rev. 2020;10(10):CD011031. PMID: 33095458. https://doi.org/10.1002/14651858.CD011031.pub3
Lemos MJ, Servidoni ACP, de Mattos ILL, et al. Reoperation after minimally invasive endometriosis surgery: a phenotype-specific meta-analysis of 22,644 patients. J Minim Invasive Gynecol. 2026. Epub ahead of print. PMID: 42498214. https://doi.org/10.1016/j.jmig.2026.07.018
Medical disclaimer
This article is for general educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always talk with a qualified healthcare provider about your symptoms and treatment options. If you think you have a medical emergency, contact emergency services right away.
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