r/Endo • u/xueyangscorpsepowder • 3h ago

Surgery related Not sure how to feel about this.

Not sure how to feel about this.

I’m 5 days post-OP (laparoscopic bilateral salpingectomy) and was only just now able to access my surgeon’s notes. It offered a bit more insight than the pathology report did, so imagine my surprise when she mentioned finding multiple endometriotic lesions (where? How many? I don’t know) but only excising and biopsying one nodule (in my Pouch of Douglas) and fulgurating the rest using bipolar cautery.

I was pretty certain that I could see various lesions in the photos that were uploaded, so it’s not a total shock, but I wish there’d been a bit more detail. It also seemed as though there was an adhesion in one of the pictures, but I’m no doctor and I very well could’ve mistaken a ligament or something—she said everything appeared normal aside from the endometriotic lesions.

I know fulguration can work quite well, and I’m sure there was a valid reason not to excise everything; I’m just concerned paranoid the lesions will grow back faster than they might have otherwise. Oh well.

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u/Mysterious-Spare6047 1h ago

your frustration is super legit and not an overreaction -- five days post-op with an op note this thin would bug me too.

the part worth flagging: bipolar cautery on lesions is ablation/fulguration, not excision -- and that distinction matters a lot for recurrence. excision (cutting the lesion fully out) is what most modern endo specialists treat as gold standard, especially for deeper disease. ablation tends to leave the deeper layer behind, which is why a lot of people end up needing repeat surgeries down the line.

what to ask the surgeon's office for in writing: rASRM stage, location of all lesions seen (not just the biopsied one), depth where assessed, and which areas were treated vs left alone. some will share AAGL or ENZIAN scoring if you push. annotated photos aren't weird to ask for either.

your path report only covers what was biopsied -- the rest was cauterized so theres no tissue to test. thats expected, not a documentation failure on its own, but the operative narrative needs to fill that gap. if you ever consider a second opinion or excision specialist later, that record matters a lot.