2025 endometriosis excision surgery with Dr. Seckin

Welcome! If you are here, you’ve likely read My Endometriosis Journey or perhaps Endometriosis Symptoms and want to learn more about symptoms and surgical preparation. I’m glad you made it here- knowing the difference between excision surgery vs ablation surgery and choosing the proper surgeon can and will significantly affect your quality of life as an endometriosis patient (or soon-to-be endo patient). 

Excision Surgery vs. Ablation Surgery for Endometriosis: What’s the Difference?

Surgery is often recommended for people with endometriosis, as it does not come up on ultrasound, sonogram or MRI. Surgery not only clinically diagnoses endometriosis, it also significantly helps the life of the patient, so long as proper treatment is given.

However, not all endometriosis surgeries are the same. The two most common surgical approaches are excision surgery and ablation surgery, and understanding the difference is critical when making treatment decisions.

What Is Ablation Surgery for Endometriosis?

Ablation surgery is the MOST common and LEAST effective type of endometriosis surgery. Ablation involves burning, cauterizing, or vaporizing only visible endometriosis lesions using heat, laser, or electrosurgical tools. This method treats the surface of the disease but does not remove the tissue entirely, and is often done by an OBGYN surgeon who also does pap smears, c-sections, and other types of procedures and treatments outside of endometriosis.

Key points about ablation surgery:

  • – Targets only visible surface lesions
  • – Does not remove deeper disease at the root
  • – Endometriosis tissue may remain beneath the surface
  • – Higher risk of symptom recurrence over time
  • – Often performed by general gynecologists, not specialists who dedicate their lives to endo

Ablation may offer temporary symptom relief… keyword: temporary. Oftentimes, the patient is back in the OR under 5 years with a worse case than they started. 

Ablation creates so much scar tissue, which endometriosis loves to feed on. A friend of mine had 22 ablation surgeries until she had her first excision, which changed her life. 

What Is Excision Surgery for Endometriosis?

Excision surgery involves cutting out endometriosis lesions, both visible and not yet visible, including disease that extends below the surface. The goal is to remove endometriosis at its root rather than simply destroying what is visible. Proper specimens are taken from the excisions and used in pathology for diagnosis (and maybe even research, depending on the case and the surgeon).

Endometriosis excision surgery is done by endometriosis specialists who dedicate their lives to endometriosis patients and the disease. Sadly, there are OBGYNs who say they do excision surgery, but they only excise a few specimens and cauterize the rest — so it is critical to go to a specialist if you want to have a proper excision surgery for endometriosis.

Key points about true excision surgery:

  • – Removes endometriosis tissue completely
  • – Allows for treatment of deep or complex disease
  • – Lower recurrence rates compared to ablation
  • – Tissue can be sent to pathology for confirmation
  • – Requires advanced surgical skill and training

Excision is widely considered the gold standard surgical treatment for endometriosis, particularly for patients with severe pain, bowel or bladder involvement, or recurrent symptoms.

Endometriosis excision surgery is highly effective and dramatically improves the quality of life for the patient.

Cheat sheet:

Excision vs. Ablation: Why the Difference Matters

Endometriosis is often compared to an iceberg: what’s visible on the surface may represent only a small portion of the disease. Ablation ‘treats’ the visible portion, while excision removes the entire lesion.

Because ablation does not address deeper disease, it is associated with higher rates of persistent or returning pain, increased likelihood of repeat surgeries, ongoing inflammation and scarring.

Excision surgery, when performed by an experienced endometriosis excision specialist, is associated with better long-term pain control and improved quality of life for many patients.

It’s critical to ask your surgeon which technique they use, how often they perform excision, and whether they address disease on the bowel, bladder, nerves, or ligaments when present.

Bottom Line

Not all endometriosis surgery is equal. While ablation may be more commonly offered, excision surgery provides a more comprehensive treatment approach by removing disease at its source. Patients deserve clear information, informed consent, and access to surgeons experienced in treating endometriosis properly.

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Not medical advice

FURTHER READING: 

My Endometriosis Journey: https://megconnolly.com/2023/03/17/my-endometriosis-journey

Endometriosis Symptoms: https://megconnolly.com/2025/12/30/endometriosis-symptoms-common-signs-that-should-not-be-ignored/

Ablation vs Excision Endometriosis Surgery: https://megconnolly.com/2025/12/30/endometriosis-excision-surgery-vs-ablation-surgery-whats-the-difference/

What to Pack/How to Prep for Endometriosis Excision Surgery: https://megconnolly.com/2025/12/30/what-to-pack-for-endometriosis-surgery-hospital-recovery-essentials/