Endometriosis Laparoscopy Recovery: How to Prepare and Heal

Recovery from an endometriosis laparoscopy usually takes up to 10 days if the surgeon only looked, and up to 6 to 8 weeks if they did surgery, such as removing endometriosis. Most people go home the same day or the day after, and neck and shoulder pain from the gas can last several days.

This guide covers the weeks before surgery, the day itself and the recovery at home. It also lists the signs that mean you should call for help.

What a laparoscopy for endometriosis is

A laparoscopy is keyhole surgery. You have a general anaesthetic, so you are asleep. The surgeon makes a small cut, usually near your belly button, and fills your belly with carbon dioxide gas so the organs are easier to see. A thin camera goes in through the cut. The surgeon may make more small cuts for the surgical tools.

A laparoscopy can confirm whether you have endometriosis, and doctors may remove areas of it during the same operation. Lesions the surgeon sees should be confirmed by a lab test of the tissue, and a negative lab result does not fully rule endometriosis out.

Laparoscopy used to be called the gold standard test for endometriosis. The 2022 ESHRE guideline changed that: it now recommends a scan (ultrasound or MRI) first, and laparoscopy for people whose scans are normal or whose treatment has not worked. A normal scan does not rule endometriosis out, so a laparoscopy can still be the right next step. Our guide on how to get diagnosed with endometriosis covers the steps before surgery.

How long you recover depends on what the surgeon does. A look-only laparoscopy is shorter. Removing endometriosis, ovarian cysts or part of the bowel or bladder takes longer. If your surgeon plans to remove endometriosis, our page on excision vs ablation explains the two main methods and what the trials show.

Before surgery: questions for your pre-op appointment

Bring written questions. Write down the answers too, because you will want them later.

• What do you plan to do: look only, or also remove endometriosis? Will you excise it or ablate it?
• Will the tissue go to a lab for testing?
• What happens if you find endometriosis on the bowel, bladder or ureters?
• Which of my medicines and supplements should I stop, and when?
• Do I need to do anything to prepare my bowel?
• When can I go back to work, drive and exercise?
• Who do I call if something feels wrong after I go home?

How to prepare in the week before

Your surgical team gives you instructions for your own operation. Follow those first. Common steps include:

• Not eating or drinking for a set time before the operation. Your team tells you when to stop. A common rule is nothing to eat or drink, not even water, after midnight.
• Stopping some medicines. You may need to stop medicines that thin the blood. Tell your surgeon about all medicines you take, and about alcohol. Do not stop a prescribed medicine on your own.
• Stopping smoking. You may be asked to stop smoking, and smoking makes your body take longer to heal.
• Arranging a lift home. You cannot drive after a laparoscopy, so ask someone to take you home. Ask them, or someone else, to stay with you for the first night if you can.

If you take hormone treatment for endometriosis, ask whether to keep taking it up to the operation and after it.

What to pack

• Loose, high-waisted trousers or a dress that does not press on your belly
• Slip-on shoes
• A long phone charger
• Lip balm
• Sanitary pads
• A small pillow to hold against your belly in the car
• Your list of medicines and allergies, and any papers the hospital asked for

Set up your home before you go

Do this while you still have energy:

• Extra pillows so you can sleep propped up
• Water, snacks, painkillers and your phone charger within reach of your bed
• Easy food in the house
• Loose clothes ready
• A step stool if your toilet is high, so sitting and standing take less effort

On the day

You change into a gown, staff check your details, and you meet the anaesthetist. In the operating room you go to sleep under general anaesthetic and feel no pain. At the end, the surgeon lets the gas out and closes the cuts with stitches or clips.

You wake up in a recovery area. Tell the nurses if you feel pain or sick, because they can give you medicine for both. Shoulder pain is common, and staff can give you pain medicine for it.

Most people go home the same day or the day after.

Endometriosis laparoscopy recovery at home

The first few days

• Gas and shoulder pain. The gas can cause belly discomfort for 1 to 2 days. Some people get neck and shoulder pain for several days, because the gas irritates the diaphragm. It goes away as your body absorbs the gas, and lying down can help.
• Pain relief. You can take paracetamol or ibuprofen for pain, unless your surgeon tells you otherwise. Take any stronger painkillers exactly as prescribed.
• Moving. Move around as much as you can. While you rest, move your ankles in circles and do other foot and leg exercises. Wear compression stockings if you were given them.
• Getting up. Roll onto your side first and push up with your arms. This puts less strain on your belly.
• Eating and drinking. Drink lots of fluids and eat a healthy diet. If you get constipated, ask your team about a stool softener.

Caring for your cuts

• Keep the wound dry for the first 24 hours. You can shower after that, in water that is not too hot.
• Do not have a bath for the first 2 weeks, or until the wound has healed.
• Pat the cuts dry. Follow your discharge notes about stitches, glue or strips.

Rules for the first 48 hours

• Do not drive for 48 hours, or until you can do an emergency stop.
• Do not fly for 48 hours.
• Do not drink alcohol for 48 hours.

Recovery time: when you can do what

Advice on timing varies between hospitals, so your surgeon's advice comes first. These are typical ranges.

Your cuts are small, so you can feel well on the outside before you have healed inside. Increase what you do a little at a time. If pain goes up after it had been going down, rest and tell your surgeon.

When to get help

Complications are rare. They include damage to an organ such as the bladder, damage to a blood vessel, a hernia and blood clots, and with endometriosis surgery, infection and bleeding.

Get an urgent appointment with your doctor or surgical team (in the UK, call NHS 111) if you recently had a laparoscopy and you have any of these:

• A high temperature, or you feel hot, cold or shivery
• Severe or continuous vomiting
• Tummy pain that is getting worse
• A bloated tummy
• Pain, swelling, bleeding, pus or redness around your cuts
• Unusual bleeding or discharge from your vagina or bottom
• Pain and swelling in one leg
• Problems when you pee
• Coughing up blood
• Difficulty breathing

Call 911 (999 in the UK) or go to the emergency department if you have:

• A very fast heartbeat
• Chest pain
• Severe difficulty breathing, such as gasping, choking or not being able to get words out

After recovery: what to expect next

Surgery usually relieves pain, but the pain can come back. You may need more surgery if symptoms return, or if surgery causes scar tissue that makes organs stick together (adhesions).

To lower the chance that period pain comes back, doctors can offer a hormonal IUD (52 mg levonorgestrel) or a combined hormonal contraceptive for at least 18 to 24 months after surgery. Ask about this at your follow-up.

Your follow-up appointment

Ask:

• What did you find, and what did you remove?
• Did the lab confirm endometriosis?
• What treatment do you suggest now?
• When can I go back to all my usual activities?
• Which symptoms should make me contact you?

Track your recovery

At your follow-up, "fine, I think" does not tell your surgeon much. A daily record does. Note:

• Pain at the cuts, deep in your belly and in your shoulders, each on a 0 to 10 scale
• Bleeding, bowel movements and any trouble peeing
• Painkillers you took
• What you managed to do, and how tired you felt
• Any new symptom, with the date

Endolog lets you log pain by body area, symptoms and medicines in one place. Keep logging for a few cycles after surgery, so you can compare your periods with how they were before. The free printable medication log helps you keep track of painkillers and other medicines.

Frequently asked questions

How long is recovery from an endometriosis laparoscopy?

It takes up to 10 days after a look-only laparoscopy and up to 6 to 8 weeks after surgery. Many people return to their normal routine in about 2 weeks.

Why do my shoulders hurt after a laparoscopy?

The carbon dioxide gas irritates the diaphragm, and you feel that in the neck and shoulders. It can last several days and fades as the gas is absorbed.

Can I take ibuprofen after a laparoscopy?

You can take paracetamol or ibuprofen for pain, unless your surgeon has told you not to.

This article is for general information. It does not replace advice from your own doctor or surgical team.