Whenever the surgery that is considered can be performed equally well and equally safely by either laparoscopy or laparotomy, the decision as to the type of incision to be used can (and in my opinion really should) include the patient.

In the hands of an experienced laparoscopic surgeon, virtually any endometriosis associated problem that can be treated by laparotomy can now be handled via laparoscopy. Laparoscopic surgery has benefited women in many ways. Differences in approach include:

(1) laparotomy

1. opening the abdomen to perform the surgery directly through a large open incision
2. cosmetically considered "disfiguring" by many younger women
3. requires a stay (usually several days) in the hospital
4. postoperative recovery may be several weeks with significant time out from work
   

(2) laparoscopy

1. minimally invasive same day surgical approach
2. a telescope is entered through an incision about 1 cm long near the umbilicus and one to three smaller incisions are also usually made in the lower abdomen for the entry of additional instruments
3. postoperative recovery usually only a few days with little time out from work.
4. little incision discomfort compared to laparoscopy incisions.