Difference Between Ablation And Excision | MyEndometriosisTeam

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Difference Between Ablation And Excision
A MyEndometriosisTeam Member asked a question 💭

Good Morning everyone,
I have seen some posts about someone saying that the doctor must have done an ablation not excision.
What is ablation?
I know mine was excision.

posted August 26, 2019
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A MyEndometriosisTeam Member

My understanding is slightly different than what @A MyEndometriosisTeam Member said, so please don't be mad at me 🤓🤓🌞

Laparoscopy is a term for surgery where they go in via small holes and don't open you up "stem to stern” (you can have a knee laparoscopy). Ablation is a term for burning things. Can be a skin cancer or, in the case of endometriosis, they burn the endo implants. Usually with either a laser or cautery of some form (basically heat to zap it at insane temperatures) but the problem is, it leaves the implant there. There's more and more data showing that ablation doesn't help; it leaves the endo there and the endo can grow back just fine. Ablation knocks it down for maybe a few months, but then the endo can get back up, keep making its own estrogen, get bigger and cause more havoc.

Excision of endometriosis is a highly specialized skill that not every gyno does. For example, my local gyno, Dr. Yun, whom I adore, took one look at my operative report with Dr. Seckin and said, "I'm happy to be your local gyno but you NEED an excision specialist. You are beyond my skill. I can do basic endo excision, but not to the extent that Dr. Seckin did." Most docs are well meaning and say they can get all the endo out, but a lot can't. And it's not their fault; they aren't properly trained. Also, to add to the confusion, it's often called a LapEx, which is fancy for "laparoscopy and excision of endometriosis". That confused me when my insurance was fighting the prior authorization for a ‘LapEx’.

A *uterine* ablation is where they go inside the uterus via the cervix to burn (ablate) the endometrial lining (the bits inside the uterus we bleed during our period every month). That's often used for women who don't want to get a period or have kids anymore, have insane heavy bleeding but don't need a hysterectomy. A gyno was thinking about it for me when I was 32, but she said she didn't recommend it then even though I didn't want kids. Because, she said after about 5 years, the endometrial lining can grow back, cause all the same problems but then your cervix is too scarred and they can't do the ablation again.

So it's important to be careful in the terminology we use, because it is super confusing.

Hope these sites might help and that y'all still want to talk to me 🤣🤣 Been doing lots of research for a few years now.

https://pacificendometriosis.com/excision-of-en...

http://centerforendo.com/lapex-laparoscopic-exc...

https://www.vitalhealth.com/endometriosis-speci...

https://knowyourendo.com/endometriosis-questions

posted August 26, 2019
A MyEndometriosisTeam Member

Think of it as the analogy of weeding. Laprascopic ablation surgery lasers and gets rid of the surface area of endo lesion (burns plant leaves and stems above-ground), but doesn't dig up the entire weed by the root (laproscopic excision surgery), so the weed grows back from the implanted root left behind. (Laproascopic ablation on endo impants is different procedure from "endometrial ablation" which burns the natural endometrial tissue inside the uterus to stop menstruation.

posted August 27, 2019 (edited)
A MyEndometriosisTeam Member

Ablation is when they use to the laser to just burn off the top of the endo they found. They can't use in certain spots, like the bowels, bladder. So they leave that behind.

posted August 26, 2019
A MyEndometriosisTeam Member

Thanks. And aaaargh, why do doctors still think a hysterectomy will cure endo?! It won't. So frustrating that we all have to become our own doctors to figure this out, amiright?

Dr. Cook's office staff is great about figuring out what your insurance will cover and what your fee will be. At least when I got an estimate 6 years ago or so. The other nice thing he said, similar to what Dr. Seckin did, is he would charge me a certain amount but then not bill me more if the insurance didn't pay what he expected. So, not sure if that's still the case but might be worth looking into.

posted August 28, 2019
A MyEndometriosisTeam Member

Word! I think we are all just trying to help each other with totally freaking confusing terminology. I wanted to just add the differentiation on the different types of ablation and laparoscopy. Because could the medical community use the same word to mean 20 different things some more? 🤣🤣

Point is, they use all these *fancy* medical words and I find I have to get a midwife, NP or PA to explain them to me. Dr. Google is often "you have Ebola, get your affairs in order". Some MDs will break them down in my experience (most likely female docs) but it's less often.

That's why I like the websites for the folks in my recommendations tab. So much more clear and helped me put a lot of things together when researching this.

GO Endo Warriors!!! We are all badasses

posted August 27, 2019

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