Laparoscopic Uterine Nerve Ablation
When ordinary endometrial (uterine lining) tissue is present at an abnormal location it irritates the involved tissues. Such occurrence is called endometriosis. Tubes, ovaries, uterus, bowel and bladder may be affected. Endometriosis may involve and penetrate these organs to different depths and cause various symptoms. Chronic Pelvic Pain (CPP), which may become constant, severe and excruciating, is the main symptom. Bladder and bowel symptoms may also be significant.

There is no ideally effective treatment for endometriosis.

Hormonal management with birth control pills (combined low dose estrogen and progesterone) or depoprovera (extended release medroxyprogesterone acetate) injections are the first line of therapy. It has only mild side effects, but its effectiveness is somewhat limited as well.

Lupron (GnRH-a or gonadotropic relseasing hormone agonist) is used as the second line remedy. Lupron is notably effective but causes significant side effects, including hot flashes, insomnia and mood swings. It can be used for a limited time, only 3 – 6 months.

Surgical intervention is sought when the conservative therapies are failing. Laparoscopic surgery is the mainstay of the operative intervention for endometriosis and CPP. Cauterization or excision of the endometrotic lesions may remove the pain triggering insult to the affected organs. Still, endometriosis may penetrate so deep that the direct surgical removal could injure the involved organs.

Laparoscopic Uterine Nerve Ablation (LUNA) is aimed to disconnect the sensory nerve network that transmits the pain caused by endometriotic lesions. LUNA may be performed using Laser, Electrical or High Frequency Ultrasonic ("Harmonic Scalpel") energy. LUNA is an outpatient surgery and only 3 – 7 days of recovery are required before returning to normal daily activities.