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Destroying the Root: Excision Surgery for Endometriosis

Destroying the Root: Excision Surgery for Endometriosis

Excision surgery for endometriosisThe goal of endometriosis surgery is destruction. Surgeons go in intent on removing the problem through whatever means possible. In many cases, this means either cutting or burning the endometrial tissue implants which have cropped up outside the uterus. Lasers and special tools are utilized to accomplish this goal.

For years, these methods have been considered the best options for the surgical removal of endometriosis, despite how frequently many patients experienced a recurrence of disease shortly after surgery. In those cases, the aggressiveness of the disease was often blamed, rather than the methods of the surgeon.

In the last decade, however, a better understanding of how to surgically remove endometriosis has been introduced to the medical world. And while most surgeons still aren’t trained in this method, it is becoming clear that excision surgery is the best hope for relief from the disease that has affected and devastated so many patients.

What Makes Excision Surgery Different?

The concept behind excision surgery requires us to look at endometriosis almost as a weed, one with roots that dig deep below the surface of what can be seen by the naked eye. For most weeds, simply destroying what remains above surface will not prevent future growth. You have to pull the roots out in order to kill the weed entirely.

Excision surgery works with this same theory, with the goal being to get at the root of the endometriosis, leaving no diseased tissue behind. It is believed the recurrences of disease, which occur quickly after surgery for some patients, takes place because not all of the endometrial tissue has been removed. This allows for continued growth, much as you would see with a weed that has roots still safely embedded in the ground.

Unlike some of the more basic surgical techniques for endometriosis, which involve burning or cutting the endo lesions that are visible on the surface, excision surgery uses specialized tools to excise all of the diseased tissue; leaving margins that are clear of endometriosis.

Why Isn’t Everyone Using Excision Methods?

While excision surgery is quickly becoming recognized as the best surgical option for the treatment of endometriosis, few surgeons are actually trained in this method. There are several reasons for this. For one, it is a specialized technique which requires advanced training and practice. For many OBGYNs who treat a variety of conditions, that extreme focus on the treatment of endometriosis simply isn’t practical.

Another issue comes down to the money which can be made from these specialized procedures. You see, most insurance companies do not differentiate in billing codes based on the method used for the destruction of endometriosis, which means that doctors cannot expect any further compensation from insurance companies in exchange for the advanced training they must go through in order to use this specialized technique. For many doctors, the motivation simply isn’t there to become trained in a technique they will not be fairly compensated for performing.

Why Should You Be Seeing a Specialist?

Anyone who has suffered at the hands of endometriosis knows how devastating and painful this condition can be. While endo is not considered to be a malignant condition, it is fair to say that the disease itself is surely not benign. Endo lesions have the capability of spreading far outside the pelvic region, affecting your overall health above and beyond your fertility. Surgical removal methods which involve simply burning or cutting the diseased tissue do not eradicate the disease from your body. They may buy you a small amount of time without symptoms, but the disease will almost always come back.

This is why seeing a specialist who is trained in the most advanced methods of surgical removal is so important. You would not visit your family doctor for the treatment of cancer, and you shouldn’t rely upon your regular OBGYN for the treatment of endometriosis. This is a complicated disease with far-reaching consequences for both your fertility and overall well-being. Seeking the help of a trained specialist who understands the importance of excision removal methods and who is up-to-date on the most advanced treatment options for endometriosis is the only way you can ensure you are receiving the best treatment possible.


Dr. Christine Traxler M.D., OB/GYN
Dr. Christine Traxler M.D., OB/GYN

Dr. Traxler is a University-trained obstetrician/gynecologist, working with patients in Minnesota for over 20 years. She is a professional medical writer; having authored multiple books on pregnancy and childbirth; textbooks and coursework for medical students and other healthcare providers; and has written over 1000 articles on medical, health, and wellness topics.  Dr. Traxler attended the University of Minnesota College of Biological Sciences and University of Minnesota Medical School,  earning a degree in biochemistry with summa cum laude honors in 1981,  and receiving her Medical Doctorate degree (MD) in 1986.

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    Please can I have a name and address of a good specialist doctor doing the Excision Surgery perfectly?

    • Dear Joanna,

      It will be best to seek a referral from your healthcare provider. We do not have list of fertility specialists to refer our clients to.

      Best wishes!