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Dr. Jeff Arrington, a renowned excision specialist and patient advocate, shares his expert perspective on when ablation might be appropriate in endometriosis treatment. He discusses the nuanced decision-making process that balances complete disease removal against fertility preservation, challenging the notion that excision is always the only acceptable approach.

• Small, superficial lesions could potentially be fully destroyed by ablation, though with more surrounding tissue damage
• When endometriosis grows around blood vessels to ovaries or the uterus, ablation may be used to preserve fertility
• Patient priorities, especially fertility concerns, should guide treatment approach decisions
• Ablation is ineffective for deeply invasive disease, especially on major organs
• Informed consent allows patients to understand risks and benefits of different approaches

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