What to Expect When Getting Endometriosis Excision Surgery

Pelvic pain between cycles and debilitating menstrual cramps can make living a normal life nearly impossible. Endometriosis is the most common reason for these symptoms, and it affects about 10% of reproductive-age women. 

Endometriosis excision surgery is the gold standard of treatment options when endometriosis symptoms interfere with your life, including persistent pelvic pain, treating lesions that have not improved with conservative treatments, and supporting fertility goals. 

Regardless of your reason for choosing endometriosis excision surgery, the minimally invasive approach is almost always the same. Continue reading to learn what the process looks like, from deciding if surgery is right for you to finding the best endometriosis excision surgeon in Los Angeles and what to expect during recovery.  

Endometriosis Excision Surgery vs. Endometrial Ablation

Endometriosis excision surgery and endometrial ablation both treat endometriosis, but they do so in two very different ways, and that difference can matter significantly if your condition is deeper or more complex: 

• Endometriosis excision surgery: During this procedure, a surgeon carefully removes excess endometriotic tissue. The procedure is performed in an operating room and under deep sedation or general anesthesia. 
• Endometrial ablation: This procedure uses heat or energy to burn or destroy endometrial tissue. This is effective for faster relief but may not work when endometrial tissue has grown deep within internal structures or onto other organs. 

Most endometriosis surgeries today are performed via laparoscopy, which uses small incisions and a camera rather than a large open incision. Laparotomy, or open surgery, is less common but typically still recommended for severe cases or specific situations where a bigger incision is safer. 

Preparing for Endometriosis Excision Surgery

Preparing for endometriosis excision surgery starts with reviewing the pre-op instructions from your surgeon’s office. Some of the most common things you will need to prepare for include: 

• Arranging a ride home, since anesthesia can leave you groggy and unsteady 
• Not eating or drinking after midnight the night before, so you’re prepared for anesthesia
• Stop blood thinners or certain supplements that raise bleeding risk
• Stop smoking for vaping ahead of time, since nicotine can slow healing and increase breathing problems during and after surgery
• Plan for four to six weeks off work to rest and recover

At home, you should set up for recovery by: 

• Stocking up on water, electrolyte drinks, and light foods that are easy on your stomach
• Keep pillows near the area you’ll be resting to support your belly when you sit up, cough, or ride in the car
• Set out loose, soft clothing that will not rub your incisions or press on your abdomen, which may be bloated for a couple of weeks 
• Arrange help with kids or pets for the first several days, since even simple bending and lifting can feel like too much

What to Expect During Endometriosis Excision Surgery

On the day of your surgery, you’ll check in, and a nurse will take your vitals, start an IV, and ask you several questions about your current health, allergies, and when the last time you ate or drank anything was. Before you are taken back for surgery, you will meet the anesthesia team and the surgeon to review the plan and ask any questions.

Most laparoscopic endometriosis surgeries are done under heavy sedation or general anesthesia, so you will not feel or remember the procedure. After you are asleep in the operating room, the surgeon makes one or more small incisions, then gently inflates the abdomen with gas so there is space to see and work. A thin camera called a laparoscope is inserted through an incision to project a magnified view onto a screen, while small instruments are inserted through other openings to carefully remove endometriotic tissue. 

When the surgeon is finished, the instruments are removed, the gas is released, and the incisions are closed with stitches and covered with small dressings. You then wake up in recovery, where the post-op team will monitor your pain, vital signs, and any side effects from the sedation or anesthesia, including nausea. You’ll feel sleepy but will likely be able to go home the same day. Within a few hours of surgery, you’ll be able to walk, eat, and drink with supervision from a support person. Some people may need to stay in the hospital longer if the surgery was extensive or the surgeon recommends additional monitoring.

Life After Endometriosis Excision Surgery

Getting surgery for endometriosis relieves pelvic pain and painful periods for many people, but it does not work the same way for everyone, and symptoms can come back over time. Recurrence risk often depends on how severe the condition was, how well the endometrial lesions were removed, and whether you use post-op hormone suppression to slow regrowth. 

Fertility is a common reason for getting surgery. Endometriosis excision surgery may improve the chance of natural pregnancy for some patients, but this also depends on your age, timing, stage of endometriosis, and other factors. Working with the best fertility surgeon in Los Angeles can increase your chances of success. 

Where to Find the Best Endometriosis Excision Surgeon in Los Angeles

Dr. Siedhoff and Dr. Mehta bring together deep MIGS training and careful surgical expertise to offer the endometriosis excision in Los Angeles, especially for those whose symptoms affect their life or fertility. 

Our state-of-the-art clinic is known for technical precision and fertility-sparing procedures, including laparoscopic excision of endometriosis. We’re committed to matching a personalized surgical plan to your goals, whether that is long-lasting pain relief, preserving reproductive options, or avoiding a hysterectomy when it is not truly necessary. 

Ready to get lasting relief from endometriosis symptoms with help from the best endometriosis excision surgeon in Los Angeles?