Excisional Therapy | Womens Excellence Blog

Excision: The Gold Standard in Endometriosis Treatment

By: Dr. Jonathan Zaidan

Excision…Excision …Excision.   It is the way to treat for sure.  Excision or resection of endometriosis is quickly becoming the gold standard of endometriosis treatment.  It is proven that excisional therapy has better outcomes for long term pain and increased fertility for those who desire children.

Excision of endometriosis is a process.   After over 900 excisional therapies, I believe this to be the best and most successful treatment protocol.

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  • Making the diagnosis via laparoscopic visualization and/or biopsy.  Every day I see people who suspect endometriosis or have been told they have endometriosis and they have not had a laparoscopy or a biopsy.  Laparoscopy is the gold standard way to make the diagnosis.  Biopsy is not always needed if good visualization is achieved.  Treatment can be started at the time of diagnosis with destruction.


  • Calm down the inflammation.  Endometriosis is an inflammatory disease that will progress without treatment.  Remember the law…”An object in motion stays in motion until some equal and opposite force acts upon it.”  That applies to endometriosis.  If you don’t blunt or stop the hormones driving the endometriosis growth (estrogen) the inflammation will continue to worsen.  STOPPING THE INFLAMMATORY RESPONSE IS PARAMOUNT FOR EXCISION SURGERY AS IT DECREASES BLOOD LOSS AND IS CLINICALLY PROVEN TO ALLOW FOR BETTER AND MORE COMPREHENSIVE ELIMINATION OF ENDOMETRIAL IMPLANTS AT THE TIME OF SURGICAL EXCISION!


  • EXCISE the implants.  Precision dissection around the pelvic organs, vasculature, pelvic nerves, bowel, bladder and ureters is imperative to eliminating disease.  I believe the best approach for this is robotic surgery.  An EXPERIENCED surgeon is necessary.


  • Continued treatment to alter the estrogen progesterone balance so you are less likely for recurrence.  Unfortunately, no one likes maintenance, but endometriosis can recur so make sure that you do not stop managing your disease…even…if you are pain free!

The Good News

Follow these steps and endometriosis is manageable and most patients can live a relatively normal life.  Make sure you and your doctor and place of treatment are on the same TEAM.  A team approach to treatment is the best therapy.

At Women’s Excellence, we are experts in treating endometriosis with excisional therapy. Our team is here to listen and develop the appropriate treatment plan for you! Contact through our chat (lower right corner) or give us a call at (248) 693-0543.

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