Endometriosis excision (or resection of endometriosis) refers to the removal of lesions of endometriosis, which are implants of cells similar to the uterine lining located outside of the uterus. Learn more about endometriosis.

This is a type of conservative management of endometriosis. The goal is to improve symptoms while preserving the uterus, tubes and ovaries, as much as possible.

Facts to Know:

• Endometriosis excision is usually done for women who are not yet finished with childbearing or who have milder disease.
• This surgery can improve pain – 80 percent of women reported improvement in their symptoms six months after surgery – but it does not cure endometriosis. Forty to 80 percent of women will have a recurrence of pain within two years of surgery. 

Women who have endometriosis, but would like to retain their uterus or get pregnant in the future, may be good candidates for removal of endometriosis. 

Like any surgical procedure, endometriosis removal is associated with certain risks. These may include excessive blood loss, an infection requiring antibiotic treatment, developing scar tissue, and childbirth complications.

During a laparoscopic excision, a thin telescope-like camera is inserted into the navel to evaluate the pelvis. Usually one to two additional 5 mm incisions in the lower abdomen are made to access the pelvis, and the endometriotic implants can be cut out and removed. For women with severe endometriosis and extensive pelvic adhesions (internal scar tissue), it is sometimes not possible to completely resect all of the endometriosis, as it may be deeply involved with vital structures such as the ureter or rectum.

DualPortGYN for endometriosis resection or excision is a pioneering new procedure, developed at The Center for Innovative GYN Care, that uses only two, 5 millimeter incisions. One incision is placed at the belly button and the other is at the bikini line. With these incisions, most GYN procedures like endometriosis excision can be performed safely in less than one hour.

Recovery times vary from one week to 6-8 weeks depending on the type of surgery. This chart details recovery time for a variety of GYN surgical techniques. It will also depend on the technique used for surgery.  An open abdominal method, which uses an eight-inch incision at the bikini line, recovery will take much longer than a laparoscopic method with much smaller incisions.

• Clearer view and fewer complications – DualPortGYN uses a technique known as retroperitoneal dissection (RPD), originally developed to remove cancerous tissue. By going behind (retro) the lining (peritoneal), the surgeon completely visualizes all of the anatomy of the pelvis, and avoids complications such as excessive bleeding, bladder injury, injury to the ureter and bladder. RPD allows surgeons to map the organs and arteries in the pelvis, much like a GPS system, reducing the time of the procedure and avoiding injury to the pelvic structures. 
• More convenience – In many situations, the surgery is performed on an outpatient basis allowing patients to go home the same day and return to most normal activity in approximately one week. 

For women who are finished having children, or who have not responded to conservative management, such as resection of endometriosis, a hysterectomy is recommended for longer-term relief.

Before undergoing surgery, you will likely have many questions for your doctor or OB-GYN. Below are some recommended questions to ask – and background information to help you weigh the answers. You can also download a printable version of these questions.

Women need to be their own best advocate, which is why getting a second opinion is always good practice. Since there are different surgical options for treating endometriosis, getting a second opinion is a way you can ask questions about how the surgery will be performed, the recovery time, and possible complications. 

Hear how removing Emily’s endometriotic implants helped her get pregnant