You may have heard you need surgery or you may have already received one… or several. Many women endure several surgeries that are found to be ineffective. While no treatments can guarantee 100% of the time that they will provide relief and restore functionality, many women are enjoying remission from a disease they thought was always going to be torturing them. When looking for a surgeon to treat endo, try to find one that keeps statistics of their patients over time. How many patients need repeat surgeries? How many feel slightly better? How many feel all the way better for a long time? Remember, we ourselves at AEEP are not doctors, but we are experienced patients who have learned things over the years. The following is our narrative of endo surgeries and why one type could be far better than the other.

Endometriosis: tissues that are like the ones growing normally inside the uterus, are growing outside of it. They basically grow, burrow in, cause scarring, and can cause organs to stick together (adhesions). Growths (lesions) might look like a superficial spot to a doctor who is doing surgery. However, that doctor has no idea how deep it is. Is it a plate or is it an iceberg?

Usually nowadays, surgeons do surgery laparoscopically. This is through three or more tiny holes in the abdomen, one of which is in the bellybutton. During laparoscopy, they look for endo. Many times, doctors are on a schedule and many times they are not totally familiar with the different ways endo can look or the different places it could be hiding.

When the surgeon sees what appears to be endo, they can do a couple of different things about it: burn it or excise it. Much of the time, they burn it (coagulate, cauterize, fulgurate…) . In this case, they use heat to try to burn the diseased tissue. Remember, they do not know if they are dealing with a plate or an iceberg, so it might look thoroughly zapped but still have angry endo growing beneath.

The other basic method a surgeon can use is called excision. This is where the doctor uses their preferred instruments to cut out the diseased tissue. When a surgeon excises the tissue, they have a better chance at getting all of it, not leaving endo under a burned area. It is more like creating a clean slate. When excision doctors include healthy tissue surrounding the diseased tissue, they can thoroughly remove diseased areas. Sometimes these doctors also use ablation (vaporization NOT coagulation) to work on tricky organs and sensitive situations, but it is not always the best with the deeper stuff. As with any infestation, getting all of it is key.

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