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Surgery

Questions about surgical options, what to look for in a surgeon, and what to expect before and after.

What surgical technique do you use — excision or ablation?

Why it matters

Excision (cutting out) and ablation (burning the surface) are fundamentally different techniques with different outcomes. Excision is generally considered the gold standard for endometriosis surgery.

Conversation guide

You might hear

I use a laser to burn off the endometriosis.

A good follow-up

I've read that excision — removing the lesion completely — may have lower recurrence rates than ablation. Do you also perform excision, or could you refer me to a surgeon who specializes in it?

Why this works: Ablation treats the surface of lesions but may leave deeper disease behind. Excision removes lesions completely and allows pathological confirmation. Studies suggest excision has better long-term outcomes for deep disease.

You might hear

I do excision for all endometriosis I find.

A good follow-up

That's great to hear. How do you handle disease in complex locations — bowel, bladder, or near the ureters? Do you work with a multidisciplinary team?

Why this works: Endometriosis in complex locations may require a colorectal surgeon, urologist, or other specialists. A surgeon who recognizes the limits of their expertise and brings in the right team is a very good sign.

Tips

It's reasonable to ask about a surgeon's training and case volume for excision
Ask whether pathology will be sent to confirm the diagnosis

How many endometriosis surgeries do you perform per year?

Why it matters

Surgical skill improves with volume and experience. This is true across all surgical specialties and is a perfectly reasonable question to ask.

Conversation guide

You might hear

I do several a month.

A good follow-up

That's helpful, thank you. Do you have experience with more advanced cases — Stage III or IV, or disease involving the bowel?

Why this works: There's no magic number, but surgeons who perform endometriosis excision regularly develop pattern recognition for identifying disease in all its forms, including subtle lesions that less experienced surgeons may miss.

What should I expect for recovery, and when can I return to normal activities?

Why it matters

Setting realistic expectations for recovery helps you plan time off work, arrange help at home, and avoid frustration if recovery takes longer than expected.

Conversation guide

You might hear

Most people go back to work in a week.

A good follow-up

What's the range you see? I'd rather plan for a longer recovery and be pleasantly surprised than the opposite.

Why this works: Recovery varies significantly depending on the extent of surgery, locations treated, and individual healing. Planning for 2-4 weeks is often more realistic than 1 week for extensive excision.

Tips

Ask about post-operative pain management before surgery so you have a plan in place
Arrange help at home for at least the first week
Ask about activity restrictions — lifting, driving, exercise

What happens if you find endometriosis in places you didn't expect during surgery?

Why it matters

Understanding the surgical plan for unexpected findings avoids being surprised by what was or wasn't done.

Conversation guide

You might hear

We'll handle whatever we find.

A good follow-up

If you find disease on the bowel or bladder, would you treat it during the same surgery, or would I need a second procedure? Do you work with other specialists in the OR?

Why this works: Some surgeons will treat all disease found in one surgery, while others may stop at areas outside their expertise. Knowing the plan helps you decide if this is the right surgical team.

Will you take photos or video during the surgery and send tissue for pathology?

Why it matters

Surgical photos document what was found and treated. Pathology confirms the diagnosis. Both create an important record for your ongoing care.

Conversation guide

You might hear

I don't usually do that.

A good follow-up

I'd really appreciate having surgical photos for my records and for any future providers. Is that something you'd be willing to do?

Why this works: Most laparoscopic systems have built-in camera recording. Photos or video of the surgical findings help future doctors understand your disease and what was treated.

Tips

Surgical photos are standard practice for many endo specialists
Pathology confirmation is important — it's the definitive diagnosis

What's the chance of endometriosis coming back after surgery?

Why it matters

Understanding recurrence risk helps with long-term planning and decisions about post-operative management.

Conversation guide

You might hear

There's about a 20-40% recurrence rate within 5 years.

A good follow-up

What can we do to reduce that risk? Would you recommend any post-operative hormonal management?

Why this works: Recurrence rates depend on the completeness of excision, disease severity, and whether hormonal suppression is used afterward. Some patients choose post-operative hormonal therapy to reduce recurrence risk.

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