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Endometriosis ~ Excision vs Ablation

Endometriosis ~ Excision vs Ablation

Endometriosis is a complex and often painful condition that affects millions of people worldwide. It occurs when tissue similar to the lining of the uterus grows outside the uterus, leading to inflammation, scarring, and even infertility. The GOLD STANDARD for Endometriosis is Excision surgery and the other type of Endometriosis surgery being, ablation. In this blog post, we'll delve into the differences between excision and ablation for treating endometriosis.


Excision Surgery
Excision surgery involves the complete removal of endometrial lesions, including the surrounding affected tissue. This technique aims to eliminate the root cause of the problem by excising all visible endometriosis implants. Excision surgery is typically performed by highly skilled gynaecological surgeons who have specialised training in this area.

Advantages of Excision Surgery

  1. Complete Removal - Excision surgery removes endometriosis lesions entirely, reducing the likelihood of recurrence.
  2. Preservation of Fertility - Excision surgery can preserve fertility by sparing healthy tissue and organs.
  3. Symptom Relief - Many people experience significant relief from pain and other symptoms after excision surgery.

Disadvantages of Excision Surgery

  1. Complex Procedure: Excision surgery requires expertise and experience, and not all surgeons are trained in this technique.
  2. Longer Recovery Time: Recovery from excision surgery may take longer compared to less invasive procedures.


Ablation Surgery
Ablation, also known as fulguration or coagulation, involves using heat or energy to destroy endometrial tissue. This technique is less invasive than excision surgery and is often performed laparoscopically.

Advantages of Ablation Surgery

  1. Less Invasive - Ablation surgery is less invasive than excision, resulting in shorter recovery times and less post-operative pain.
  2. Widely Available - Many gynaecological surgeons are trained in ablative techniques, making it a more accessible option for some patients.

Disadvantages of Ablation Surgery

  1. Risk of Incomplete Removal - Ablation may not completely remove deep-seated or widespread endometriosis lesions, leading to a higher risk of recurrence.
  2. Potential Damage to Surrounding Tissue - The heat or energy used in ablation surgery can inadvertently damage surrounding healthy tissue.


Choosing Between Excision and Ablation
The choice between excision and ablation depends on various factors, including the severity and extent of endometriosis, the patient's symptoms, desire for fertility preservation, and the expertise of the surgical team. In general, excision surgery is considered more effective for complete removal of endometriosis lesions and long-term symptom relief, especially in cases of deep infiltrating or extensive disease. In saying that excision is also the Gold Standard for Endometriosis surgery and there are many articles and medical journals supporting this evidence.

It's crucial for patients to consult with a knowledgeable gynaecological surgeons who can assess their individual situation and recommend the most appropriate surgical approach based on their specific needs and goals.

In conclusion, both excision and ablation are surgical techniques that are available for treating endometriosis, but they differ in terms of invasiveness, efficacy, and recovery times. Patients should work closely with their healthcare providers to make informed decisions about their treatment options and prioritise long-term relief and well-being which is why we we are so passionate about reiterating how important Excision surgery is. 

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