08/27/2025
This is severe endometriosis. The first picture is the typical “kissing ovaries” - where deep infiltrating endometriosis has caused significant scarring and the ovaries are stuck to each other as well as to the back of the uterus - and in this case - along the back of the va**na, cervix, and the re**um.
“Freeing up the scar tissue” is a term I hear when patients have had surgery with surgeons who don’t do a lot of surgery for endometriosis. Freeing these structures so they are no longer stuck together does not address the endometriosis, does not improve pain, and doesn’t improve fertility.
The second picture is how we address endometriosis. The endometriosis has all been excised. The vital structures like the ureters and the pelvic nerves have been cleared of disease and meticulously preserved. The re**al disease has been shaved away. Normal anatomy has been restored. The ovaries have been freed and elevated temporarily to prevent them from becoming scarred to the side of the pelvis as healing occurs.
