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02/06/2021

Just a few months ago in September, Chrissy Teigen revealed that she had been hospitalized due to excessive bleeding during pregnancy. Ultimately, she suffered a miscarriage, and mourned the loss of what would've been her third child with husband, singer John Legend. Now, Teigen, 35, is at the hospital again, this time for endometriosis surgery.

She revealed the news of Thursday's scheduled surgery the day before on Twitter in an emotional post, sharing that her surgery also coincided with with her original due date for Jack, her unborn baby. "My little jack would have been born this week so I'm a bit off," she wrote. "I truly feel kicks in my belly, but it's not phantom. I have surgery for endometriosis tomorrow…but the period feeling this month is exactly like baby kicks. Sigh."

In another tweet later on, Teigen asked her followers for information on their experiences with endometriosis surgery. "What is the recovery-difficulty level? Like can I make soup after," she asked.

Teigen got thousands of responses, including one from fellow high-profile endometriosis sufferer, Top Chef host Padma Lakshmi, who wrote, "Give me a call, dear. I've had five surgeries. I'll tell you all about it. And have John make the soup."

Endometriosis is a condition that affects a huge number of women—by some estimates, more than 11% of women between the ages of 15 and 44 in the US alone, per the US Office on Women's Health (OWH)—and that number may not be completely accurate due to women who may not have a confirmed diagnosis. Here's what you need to know about why someone might need surgery for endometriosis, and what that can look like.

What is endometriosis, and why might someone need surgery for it?

Endometriosis—sometimes referred to as "endo"—is a condition in which tissue that's similar to the lining of the uterus grows outside the uterus and on other parts of the body where it doesn't belong, such as the ovaries and fallopian tubes. While endometriosis is particularly common in women in their 30s and 40s, it can affect girls as young as 15.

The OWH says endometriosis can cause symptoms like painful period cramps, chronic pain, bleeding or spotting between periods, and digestive issues. Endometriosis may also cause digestive issues like diarrhea, constipation, bloating, or nausea, and in serious cases, can lead to infertility.

While medical therapies like hormones can be used to relieve pelvic pain from endometriosis, some patients may need surgery, Anita Sit, MD, chief of gynecology at Santa Clara Valley Medical Center in San Jose, California, tells Health. "We also see patients who suffer from ovarian cyst associated with endometriosis, called 'endometriomas,'" she adds. "Often, they need surgery to remove these cysts."

Dr. Sit says other reasons for endometriosis surgery include infertility evaluation and treatment, or surgical removal of the endometriosis if it's affecting other organ function, such as the bladder.

What does surgery for endometriosis involve?

The most common surgical treatment for endometriosis is a procedure called a laparoscopy, which is also known as keyhole surgery or minimally-invasive surgery. Normally carried out under general anesthetic, a laparoscopy allows a surgeon to view the inside of the abdomen and pelvis via several small incisions, into which a slim instrument called a laparoscope is inserted. Any implants, scar tissue, or endometriomas can be removed at that time.

According to Mayo Clinic, a surgeon can often fully treat endometriosis during the laparoscopy, eliminating the need for further surgery. "Sometimes, the endometriosis growth implants can be removed intra-abdominally thought the laparoscopy, or robotic-assisted surgery," Dr. Sit says.

A laparoscopy may also be used as part of a diagnosis or staging for the disease, ranging from stage 1 (minimal) through stage 4 (severe). (Note, however, that endometriosis severity stages are not like the stages of cancer that can have prognostic value.) Endometriosis stages also don't correlate to the impact of chronic pain or infertility on a patient, nor do they necessarily give guidance on how to treat endometriosis for different patients, Hugh Taylor, MD, vice president of the American Society for Reproductive Medicine and chair of obstetrics, gynecology, and reproductive science at Yale School of Medicine, previously told Health.

Another type of surgical procedure for endometriosis is a laparotomy—and this one is a major procedure involving an incision in the abdominal wall (it's sometimes referred to as open surgery for this reason). This lets the surgeon get inside the abdomen to identify and repair any emergency problems. But laparotomies are a bit more rare, and are only usually carried out when the patient cannot be easily treated via laparoscopy.

Lastly, hysterectomies are also an option for women undergoing surgery for endometriosis—but they're technically considered a "last resort," Sawsan As-Sanie, MD, a gynecological surgeon at the University of Michigan's Von Voigtlander Women's Hospital, previously told Health.

During a hysterectomy, the surgeon removes the womb (uterus). In some cases, the ovaries and fallopian tubes may also be removed, Dr. Sit says. A hysterectomy ends menstruation, whatever the age of the patient, and makes pregnancy impossible. Apart from severe endometriosis, reasons for a hysterectomy include abnormal bleeding, uterine prolapse, and cancer, says Cleveland Clinic, and as you'd expect, the recovery period is longer (around four to six weeks) than for other types of endometriosis surgery.

The thought regarding a hysterectomy as treatment for endometriosis is that, without a uterus, the women will no longer experience the debilitating symptoms, but even that's not promised. "For many women, [a hysterectomy] brings relief," Dr. As-Sanie said. "If they had heavy, painful periods before, hopefully this will stop and their pain gets a lot better, although there's no guarantee." Still, between 10% and 25% of endometriosis sufferers who undergo hysterectomy continue to report persistent pain after surgery, she added, although it's unclear what causes it or why it only affects some women.

We don't know what type of surgery Teigen is having, but she shared another update on Instagram Stories Thursday morning as she waited in the hospital for her procedure, writing, "Endometriosis surgery. Please endo this pain." Whichever type of surgery she has, here's to hoping she has a speedy recovery—and can make her own soup ASAP.

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