Dr. Stepp completed his fellowship in Minimally Invasive Gynecologic Surgery (MIGS) at the Cleveland Clinic where he worked with the Fertility Specialists treating endometriosis, fibroids, and other complex benign conditions.

yellow ribbon for endometriosis

What is Endometriosis?

Endometriosis is a condition where the glands and tissue that are normally found inside the lining of the uterus, are located outside the uterus. During a woman's menstrual cycle, the lining of the uterus thickens as it gets ready to nourish the embryo that will ultimately become a growing baby. If the woman doesn't get pregnant, then the lining will come off causing bleeding and a "period" happens. One of the possible theories for the origins of endometriosis is that some of those cells or tissue travel up through the fallopian tubes and implant on other organs inside the pelvis. During each cycle, the endometriosis implants grow and respond to the hormones just like they were in the uterus. This can lead to the formation of adhesions, scar tissue, and inflammation. The condition can cause pain, especially during menstruation, and may contribute to fertility issues. If they implant on the ovary, they can grow to form cysts called endometriomas. This can be very painful around the time of a woman's period.

How is Endometriosis treated?

A clinical diagnosis of endometriosis often involves a combination of medical history review, physical examination, and imaging studies. However, the gold standard and only sure way for definitive diagnosis is laparoscopy, a surgical procedure in which a thin tube with a camera is inserted through a small incision to visualize, biopsy, and treat endometriosis.

If you have been diagnosed with endometriosis, you should understand the treatment options available. Many patients do very well with anti-inflammatory medications to treat the pain and hormones to suppress the endometriosis. However many patients will need or choose surgery. Dr. Stepp feels strongly that endometriosis should be excised. Because the depth of endometriosis lesions is difficult to detect, Dr. Stepp does NOT burn, ablate, laser or cauterize the surface. Although surgically removing the implants is more difficult, patients do better if all the endometriosis is removed. This is especially true for patients that have had prior surgery for endometriosis. Dr. Stepp is specifically trained in Minimally Invasive Gynecologic Surgery to remove all endometriosis while minimizing risk to the delicate structures of the pelvic anatomy and preserving fertility.

If you are considering surgical intervention for endometriosis, it is essential to discuss the pros and cons of each approach with your healthcare provider to make an informed decision based on your individual needs and circumstances. Dr. Stepp has been performing laparoscopic and robotic endometriosis excision surgery for 20+ years. If you have been told that you have endometriosis that can't be removed from the ovaries, ureter, bladder, bowel, appendix, colon or rectum, please contact Dr. Stepp for a consultation.

Key reasons why excision stands out as a more effective and beneficial option compared to ablation.