How to Find and Vet an Endometriosis Excision Specialist

You've been told your pain is "normal" for years. You've cycled through birth control, heating pads, and emergency room visits — and now you're finally considering surgery, but you have no idea how to find the right surgeon.

Why Does the Right Surgeon Matter?

Approximately 40–45% of women experience pain recurrence after endometriosis surgery, and the probability of needing a repeat operation reaches 50% within 5 to 7 years.¹ Those numbers shift dramatically based on who performs the surgery. A 2025 population study of over 83,000 patients found that patients of high-volume complex endometriosis surgeons had a reoperation rate of 17.8%, compared with 32.9% for low-volume surgeons.¹ High-volume surgeons also had the lowest 30-day complication rate at 5.5%, with a statistically significant 16% reduction in complications compared to low-volume surgeons.¹

Directories can tell you a surgeon's name, but they cannot tell you their annual case volume, complication rate, or whether they routinely send tissue to pathology. Those details matter more than any listing.

If you're still deciding whether surgery is right for you, see our guide to excision vs. ablation for endometriosis.

What Is the Difference Between a GYN and an Excision Specialist?

A general OB-GYN completes roughly 4 years of residency training, but endometriosis excision — especially for deep infiltrating disease — requires advanced skills that go well beyond standard residency. Fellows in Minimally Invasive Gynecologic Surgery (FMIGS) complete a median of 89 endometriosis-specific procedures during their 2-year fellowship, with some programs averaging over 108.³ A general gynecologist may primarily use ablation (burning the surface of lesions), while an excision specialist cuts disease out at the root and sends it for pathologic confirmation.

This distinction matters because a 2024 Cochrane review of 9 trials (578 women) found that endometrioma recurrence was 9.1% after excision versus 36.9% after ablation, and painful period recurrence was 19.5% versus 49.3%.⁴ Deep infiltrating endometriosis — which affects the bowel, bladder, or ureters — requires even more specialized skill and often a multidisciplinary team including colorectal and urologic surgeons.²⁵

Where Should You Start Your Search?

Most women begin their search online, and three directories come up repeatedly. Each has strengths and limitations.

Nancy's Nook Endometriosis Education

Nancy's Nook is a popular Facebook-based educational group that maintains a list of recommended excision surgeons. It has helped thousands of patients find specialists. However, it is a patient-curated resource, not a peer-reviewed medical directory. Surgeons are added based on community recommendations and the group administrator's vetting, not on published outcomes data or verified case volumes. It can be a reasonable starting point, but it should not be the only tool used to evaluate a surgeon.

iCareBetter Provider Directory

iCareBetter is an online directory that states it vets surgeons based on surgical skill, patient outcomes, and peer recommendations. It provides more structured profiles than Nancy's Nook. Like any directory, it cannot substitute for asking a surgeon directly about their training, volume, and complication rates.

Endometriosis Foundation of America

The Endometriosis Foundation of America (EndoFound) offers educational resources and a physician finder. It is a well-known nonprofit, but its directory is broad and includes providers at various experience levels. Use it as one input among several.

No single directory can replace your own vetting process. Directories are a starting point — not a finish line. The 8-criteria scorecard below is designed to help you evaluate any surgeon, regardless of where you found their name.

What Questions Should You Ask a Prospective Surgeon?

Before choosing an endometriosis surgeon, ask these questions and use them as a personal scorecard. Rate each answer on a scale of 1 (concerning) to 5 (excellent). For a deeper pre-op checklist, see questions to ask your surgeon before endometriosis excision.

1. Credential level: Are you fellowship-trained in minimally invasive gynecologic surgery (FMIGS) or gynecologic oncology? Board certification alone does not guarantee advanced excision training.³
2. Annual case volume: How many endometriosis excision surgeries do you perform per year? Research defines high-volume as 12–23+ cases per year, with the best outcomes at 24 or more. Ask for a specific number.¹
3. Deep infiltrating disease experience: What percentage of your cases involve deep endometriosis (bowel, bladder, ureter, or rectovaginal)? An experienced specialist manages deep disease in a large share of their caseload — one large series reported 84% of cases involved deep endometriosis.⁷
4. Bowel and bladder comfort: Do you perform bowel or bladder resections yourself, or do you work with a colorectal or urologic surgeon? International guidelines recommend interdisciplinary care when endometriosis involves the bowel, bladder, or ureter. A surgeon who says "I don't operate near the bowel" may leave disease behind.²⁵
5. Residency and fellowship training: Where did you train, and did your program emphasize excision over ablation? FMIGS fellows from programs with fellowship-trained directors completed nearly twice as many endometriosis surgeries (108 vs. 58).³
6. Multidisciplinary team: Do you have colorectal surgery, urology, and/or thoracic surgery available in the operating room when needed? Population studies of specialized endometriosis centers report that roughly 28% of deep endometriosis surgeries require interdisciplinary involvement.⁶
7. Recurrence and follow-up protocol: What is your long-term follow-up plan? Even with complete excision by an experienced surgeon, up to 28% of patients may need a repeat procedure within 10 years. A good specialist has a plan for monitoring and managing recurrence.⁶
8. Pathology protocol: Do you send all excised tissue to pathology? Histologic confirmation is the gold standard for diagnosis. If a surgeon does not routinely send specimens, that is a red flag.²⁷

What Are the Red Flags When Vetting an Endometriosis Surgeon?

Research shows that up to 65% of women with endometriosis are initially misdiagnosed, and the average diagnostic delay is 5 to 12 years.²³ Red flags that a surgeon may not be the right fit include:

• They primarily use ablation, not excision. Ablation has significantly higher recurrence rates for endometriomas (36.9% vs. 9.1%).⁴
• They cannot give you a specific annual case number. If a surgeon is vague about volume, they may fall into the low-volume category (6 or fewer cases per year), where 80% of endometriosis surgeries currently take place.¹
• They dismiss your symptoms or suggest "just getting pregnant." Endometriosis is a chronic systemic inflammatory disease, not a condition that pregnancy cures.²
• They do not mention pathology. Without sending tissue for analysis, there is no way to confirm complete excision or rule out other conditions.⁷
• They have no plan for what happens after surgery. Medical therapy after surgery is recommended to reduce recurrence risk, and a specialist should discuss this proactively.⁵

Many articles frame the excision-vs.-ablation debate as settled for all types of endometriosis. In reality, high-quality evidence comparing excision to ablation for superficial peritoneal lesions is still lacking — the strongest data favoring excision applies to ovarian endometriomas and deep disease.²⁴

What Training and Credentials Should You Look For?

FMIGS fellowship graduates complete a median of 510 total surgical cases over 2 years, including a median of 89 endometriosis-specific procedures.³ This is substantially more endometriosis experience than a standard OB-GYN residency provides. Other credentials that signal advanced training include:

• AAGL (American Association of Gynecologic Laparoscopists) fellowship completion
• Board certification in gynecologic oncology (these surgeons are trained in complex pelvic dissection)
• Affiliation with a certified endometriosis center (such as those recognized by the Endometriosis Foundation of America or equivalent European designations)
• Active involvement in endometriosis research or teaching

A surgeon does not need every credential on this list, but at least one marker of advanced, endometriosis-focused training beyond general OB-GYN residency is important.

What About Insurance, Cost, and Travel?

Endometriosis specialists are in short supply, and many patients live far from the nearest appropriately skilled practitioner.⁷ This means travel may be necessary. For a full pre-op prep checklist, see how to prepare your body for endometriosis surgery. A few practical considerations:

• Insurance. Call your insurance company before your consultation. Ask whether the surgeon is in-network and whether excision surgery requires prior authorization. If the surgeon is out-of-network, ask about single-case agreements or out-of-network exceptions — especially if no in-network excision specialist is available in your area.
• Cost. Out-of-pocket costs for excision surgery can range widely. Ask the surgeon's office for a cost estimate that includes the facility fee, anesthesia, and any additional specialists (colorectal, urology) who may be involved.
• Travel. If you are traveling for surgery, confirm the expected hospital stay (typically 0–2 days for laparoscopic excision) and plan for 1–2 weeks of local recovery before flying home. Ask whether the surgeon's team offers virtual follow-up visits.

Why Do Second Opinions Matter?

A systematic review found that persistent pain after endometriosis surgery occurs in approximately 25% of patients, and up to 1 in 4 women who undergo minor conservative surgery require additional endometriosis surgery.²⁷ A second opinion can help determine whether surgery is the right next step, whether the proposed surgical plan is thorough enough, and whether a different approach might reduce the chance of reoperation. For a deeper dive, see should I get a second opinion before endometriosis surgery?

Second opinions are especially valuable if:

• A surgeon recommends ablation rather than excision for known deep disease
• You have already had one surgery with incomplete relief
• Bowel, bladder, or ureteral involvement is suspected but the surgeon does not work with a multidisciplinary team

When to Seek Care

Contact a healthcare provider promptly if you experience:

• Pelvic pain rated 7/10 or higher that is not controlled by over-the-counter medications
• Fever above 100.4°F (38°C) after any pelvic surgery
• Blood in your urine or stool, which may indicate deep endometriosis involving the bladder or bowel²
• Pain that causes you to miss 3 or more days of work or school per month
• Symptoms that have persisted for 6 months or longer without a clear diagnosis

These are signs that evaluation by an endometriosis specialist — not just a general gynecologist — may be warranted.

The content on this page is for educational purposes only and is not medical advice. Always consult your healthcare provider for individualized guidance. Read our editorial policy.