Excision Surgery: Removing the Disease at the Root
Endometriosis surgery done correctly removes each implant completely — beneath the surface, down to the root — and sends the excised tissue to pathology for histologic confirmation. This is excision. It is not the same as ablation, which destroys only the visible surface of an implant and leaves the deeper tissue behind.
Dr. Andrei performs excision — not ablation — at every operative endometriosis case. The distinction matters because excision is associated with longer recurrence-free intervals, and because the tissue removed by excision can be confirmed by pathology. Ablation destroys tissue without providing a specimen. For women who have had ablation and experienced returning symptoms, residual unexcised disease is the most likely explanation.
This section also covers adhesiolysis — laparoscopic release of pelvic scar tissue that causes chronic pain — and ovarian cyst removal, including endometriomas. All five procedures are performed at McLaren Lapeer, McLaren Flint, Henry Ford Rochester, and Lapeer County Surgery Center depending on the procedure and clinical complexity.
Choose the Procedure That Matches Your Diagnosis
Each page below explains who the procedure is for, what Dr. Andrei does differently, and what recovery looks like.
Systematic laparoscopic removal of all visible endometriosis implants at the root — not a surface burn. All excised tissue sent to pathology for histologic confirmation. The most important distinction in endometriosis surgery.
Endometriosis Excision Surgery →For complex or deep infiltrating endometriosis near the bowel, bladder, or uterosacral ligaments — the da Vinci® system provides three-dimensional visualization and wristed instrument precision that enhances excision safety and completeness.
Robotic Endometriosis Treatment →The primary surgical approach for most endometriosis presentations — systematic excision through small incisions with complete pelvic survey, pathology confirmation, and same-day discharge for most patients.
Laparoscopic Endometriosis Surgery →Pelvic scar tissue — from prior surgery, endometriosis, or pelvic infection — causes chronic pain by binding organs in abnormal positions. Laparoscopic adhesiolysis releases these bands and restores normal pelvic anatomy.
Adhesion Treatment →Laparoscopic ovarian cystectomy removes the cyst while preserving as much healthy ovarian tissue as possible — including endometriomas, dermoid cysts, and persistent simple cysts. Outpatient at LCSC for most cases.
Ovarian Cyst Removal →The Most Important Distinction in Endometriosis Surgery
Ablation uses heat or laser energy to destroy the surface of endometriosis implants. It is faster and technically simpler — but it leaves the deeper layers of the implant intact. Endometriosis tissue burned at the surface can regrow from what is left behind. Excision cuts beneath each implant, removing it entirely.
- Excision removes the implant including its deeper layers
- All excised tissue sent to pathology for histologic confirmation
- Excision evidence supports longer recurrence-free intervals
- Ablation leaves deeper disease in place — symptoms can return
- Ablation provides no specimen for pathologic confirmation
- Dr. Andrei performs excision at every operative endo case
“Ablation is a faster operation. It also leaves the disease behind. Every laparoscopic endometriosis case I perform is an excision case — because that is what it takes to actually remove the disease.”
- Board-Certified — Obstetrics and Gynecology
- FACOG — Fellow, American College of OB/GYN
- MD, PhD — dual academic credentials
- da Vinci® robotic surgical certification
- GYN-only practice — every surgery is a GYN surgery
- Private practice — no residents, no handoffs
Excision. Confirmation.
Lasting Relief.
If endometriosis is affecting your quality of life — or if prior surgery did not hold — bring your imaging and operative reports to a consultation with Dr. Andrei. She will tell you directly whether excision surgery is the right next step.
The information on this page is intended for educational purposes only and does not constitute medical advice. Individual symptoms, diagnoses, and treatment options vary significantly. Reading this content does not establish a physician-patient relationship with Dr. Ramona D. Andrei or Lapeer Women’s Health. If you are experiencing a medical emergency, call 911 or go to the nearest emergency room immediately. Please consult a qualified healthcare provider for advice specific to your situation. Content reviewed by Dr. Ramona D. Andrei, MD PhD FACOG.
Gynecologic care for women of every age
Lapeer Women’s Health — Rochester Hills
2710 S Rochester Rd, Suite 2
Rochester Hills, MI 48307
Serving patients in Lapeer, Rochester Hills, and surrounding communities throughout Southeast Michigan.