Endometriosis pain is often dismissed for years. CIGC treats the disease — not just the symptoms.
Normal imaging does not rule out endometriosis. Many patients come to CIGC after years of worsening pelvic pain, failed medication, incomplete surgery, or being told nothing is wrong. CIGC focuses on specialist evaluation and complete excision when surgery is appropriate.
If you have severe pelvic pain, pain with periods, pain with sex, bowel or bladder symptoms, or suspected Stage III/IV disease, you need a surgeon who treats complex endometriosis every day.
- 🎓 GYN-Oncology Trained
- ✏ Surgery Only — Not Obstetrics
- 📋 6 Peer-Reviewed Publications
- ✅ 20,000+ Procedures Performed
- 📍 Rockville, MD · Reston, VA · Secaucus, NJ
Severe pelvic pain with normal tests is not “normal.” It may be missed endometriosis.
Endometriosis can be difficult to diagnose because ultrasound and routine imaging may not show the disease. Many women are told their pain is normal, psychological, or something they must manage. CIGC evaluates the pattern of symptoms and the likelihood of disease — not just the imaging report.
Common signs patients report
- Periods that become more painful over time
- Pelvic pain that interrupts work, school, or family life
- Pain with sex, bowel movements, or urination
- Pain that returns after medication or prior surgery
Why patients are missed
- Normal ultrasound or nondiagnostic imaging
- Symptoms minimized as “bad cramps”
- Medication used to suppress symptoms without removing disease
- Incomplete prior surgery or ablation
Why CIGC is different
- Excision-focused surgery, not surface burning
- Complex disease experience including bowel, bladder, and ureter involvement
- Same-day surgery center model when appropriate
- Published outcomes and specialist surgical standards
Endometriosis is often missed because imaging can look normal and symptoms are minimized
Many patients reach CIGC after years of worsening pelvic pain, normal imaging, failed medication, failed prior surgery, or being told their pain is part of normal periods. The issue is not whether pain exists — it is whether the surgeon can find and remove the disease completely.
Common Patient Story
- Years of severe period pain
- Pain with sex, bowel movements, or urination
- Normal ultrasound or nondiagnostic imaging
- Repeated dismissal before diagnosis
Complex Disease
- Stage III/IV endometriosis
- Bowel, bladder, ureter, or rectovaginal disease
- Frozen pelvis and adhesions
- Prior incomplete surgery
Why CIGC
- Advanced excision-focused surgery
- Same-day surgery center model
- Published outcomes and complex-case experience
- In-network options for many patients
Dr. Natalya Danilyants developed the surgical techniques used at CIGC and has published their outcomes in peer-reviewed medical journals. Every CIGC surgeon is personally trained in these techniques and performs surgery according to the same operative standards and quality benchmarks — whether your procedure is performed in Maryland or New Jersey.
Why CIGC is the better option for endometriosis
RET — complete excision, not ablation — and no general surgeons required
- Retroperitoneal Excision Therapy enters behind the abdominal lining to remove disease at its root — not burn the surface and leave disease behind
- CIGC never uses ablation. Burning leaves disease behind and leads to recurrence.
- CIGC surgeons are GYN-oncology trained and remove endometriosis from the bowel, bladder, ureters, and diaphragm without a general surgeon or urologist — one team, one procedure, one same-day discharge. Other surgeons refer these cases out, adding cost, larger incisions, and longer recovery.
Surgery first — what medication will never achieve, surgery accomplishes in one procedure
- Orilissa, Myfembree, Lupron — suppress symptoms while ovulation is blocked. Disease is not removed. Symptoms return when medication stops. Menopausal side effects include hot flashes, bone density loss, mood changes, and vaginal dryness — with intolerance often resulting in discontinuing treatment shortly after starting.
- Surgery removes the disease. Immediate pain relief. No months of waiting. And for fertility patients: excision restores normal anatomy, decreases inflammation, removes disease and scar tissue, and can enhance fertility — while medication stops ovulation and can decrease it.
Seven-year published outcomes — not just patient satisfaction
- Long-term pain relief, symptom recurrence, and fertility outcomes published in peer-reviewed journals
- CIGC publishes data — not star ratings. Ask any surgeon for their PubMed ID and verify it yourself at pubmed.ncbi.nlm.nih.gov.
In-network — no cash payment to your surgeon required
- Covered by most major insurance plans — the highest level of endometriosis excisional care without paying cash or going out of network
- Endometriosis does not discriminate. Neither should your surgeon.
You have been told the best endometriosis surgery costs $15,000 to $50,000 cash. That is not true.
Cash-based endometriosis specialists charge $15,000–$50,000 upfront before surgery. What produces better surgery is not how you pay — it is surgical training, technique, and published outcomes. CIGC meets all three criteria and is covered by your insurance.
What cash-based billing actually looks like
- 1. Surgeon collects $15,000–$50,000 cash from you before surgery
- 2. Surgery performed at an in-network hospital — facility fee billed in-network, surgeon fee is not
- 3. Surgeon files your insurance claim as a courtesy after surgery
- 4. Your insurance reimburses $750–$1,500 on a $20,000+ surgeon fee. Many additional out-of-network providers (assistants, colorectal surgeons) may also bill separately.
Net out-of-pocket: $18,500–$49,000+. At CIGC: your normal in-network cost-sharing only — approximately $1,000 at 20% coinsurance at a freestanding surgery center.
What actually produces better surgery
- ✓ GYN-oncology training — the only training covering bowel, bladder, ureter, and diaphragm surgery without additional surgeons
- ✓ Complete excision — not ablation. Every CIGC case: zero ablation, all disease removed at the root
- ✓ Published peer-reviewed outcomes — seven-year follow-up, AJOG 2021, verifiable on PubMed
- ✓ In-network with most major insurance plans — no cash upfront, no billing surprise, no reimbursement chase
CIGC has published a complete guide to how cash-based endometriosis surgery billing works — including the four-step process, the HOPD trap, and the questions to ask any surgeon before paying. Read the full guide →
Ready to find out if CIGC is right for you?
Schedule a consultation — reviewed by Dr. Danilyants or the surgical team. In-network. Rockville, MD · Reston, VA · Secaucus, NJ · Telehealth.
Thank you — we’ve received your request.
A member of the CIGC surgical team will review your information and reach out shortly. For immediate assistance, call 1-888-SURGERY.
What every endometriosis patient should know before choosing a surgeon
Dr. Danilyants explains why most endometriosis surgery leaves disease behind — and what complete excision makes possible that ablation never can.
Three things CIGC has demonstrated simultaneously through actual data and published literature that no other endometriosis practice has achieved
Every claim below is sourced from CIGC’s peer-reviewed published journal articles and actual data from patients who have undergone endometriosis surgery at CIGC.
Cases the published literature documents only as open, inpatient surgery
A 32 cm endometrioma — about 12.5 inches — removed laparoscopically, same-day, from a freestanding surgery center. 28 masses at or above 6 inches, all same-day. Stage IV disease involving the bowel, bladder, ureters, and diaphragm — excised completely, not burned, not left behind. No published series anywhere documents same-day discharge at this level of complexity.
All disease removed — not ablated, not managed, not left behind
RET removes endometriosis at its source — including involvement on bowel, bladder, ureters, and diaphragm — without a general surgeon or urologist. One surgical team. One procedure. Seven-year follow-up data published documenting long-term pain relief, recurrence rates, and fertility outcomes.
Covered by most major insurance plans — no cash payment to your surgeon required
Cash-based endometriosis specialists charge $20,000 or more for surgery available in-network at CIGC. No cash payment to your surgeon is required for the highest level of endometriosis excisional care. CIGC performs the most complex cases at a freestanding surgery center, covered by most major insurance plans.
A 32 cm endometrioma, removed laparoscopically, same-day — from a surgery center
If CIGC can remove a 32 cm endometrioma and send the patient home the same day, they can certainly handle every case of endometriosis — from the most complex Stage IV involving multiple organ systems to the most straightforward presentation. One team of pelvic surgery experts handles bowel, bladder, ureter, and diaphragm involvement — no additional surgeons, no larger incisions, no longer recovery.
The point is not the records. The point is what the records prove. There is no endometrioma too large, no stage too advanced, and no organ involvement too complex for CIGC to treat minimally invasively — all disease removed, sent home the same day, at a surgery center, covered by most insurance. Whatever the severity of your disease, it is within this range.
RET excision vs. ablation vs. medical management
Three approaches, three very different outcomes for pain relief, disease recurrence, fertility, and what is actually removed.
All disease removed at its source. Same-day. In-network.
- RET enters behind the abdominal lining to remove disease at its root — not surface-burn it
- Complete excision of Stage IV disease on bowel, bladder, ureters, ovaries, and diaphragm — no general surgeon or urologist required
- Immediate pain relief — surgery accomplishes in one procedure what medication never can
- Can improve fertility — excision restores normal anatomy, decreases inflammation, removes disease and scar tissue. Medical therapy stops ovulation and can decrease fertility. Excision does not.
- Two to three small incisions — same-day discharge, back to work in about one week
- Seven-year published follow-up data
- In-network with most major insurance plans
Surface treated. Root of disease left behind.
- Burns the surface of endometriosis — does not remove the disease
- Root of the implant remains — disease regrows from the tissue left behind
- Cannot safely treat disease on bowel, bladder, or ureters — these cases are referred to general surgeons and urologists at higher cost, larger incisions, and longer recovery
- Many OB/GYNs and “MIS specialists” use ablation because they are not trained in advanced excision
- Higher recurrence rate than complete excision
- Repeat surgeries frequently required
Symptoms suppressed. Disease not treated.
- Orilissa, Myfembree, Lupron, birth control — disease is not removed
- Medical therapy does not improve fertility — stops ovulation and can decrease it
- Menopausal side effects: hot flashes, bone density loss, mood changes, vaginal dryness
- Intolerance to medication often results in discontinuing treatment shortly after starting
- Symptoms return when medication stops
- Does not address Stage IV disease, organ involvement, or large endometriomas
What a star rating does not tell you about your endometriosis surgeon
Many practices report good reviews for routine endometriosis surgery. What a star rating does not tell you: whether disease was completely excised or only burned, whether your surgeon can operate on bowel and bladder without involving other surgeons, or whether those reviews were collected before or after any surgery occurred.
Does your surgeon use excision or ablation — and can they treat bowel, bladder, and ureter involvement without a general surgeon or urologist? Most cannot. CIGC uses only excision, never ablation, and handles the full range of organ involvement in a single procedure.
Many practices collect patient reviews through automated services that send a survey immediately after a consultation or office visit — before any surgery has occurred. CIGC and Dr. Danilyants do not do this. Every CIGC review is a post-surgery review. Read them yourself: you will find patients describing their surgical results — and their pain-free lives.
Does your surgeon publish outcomes in peer-reviewed journals? CIGC does. Seven-year follow-up data. A satisfied patient after a routine laparoscopy is not the same evidence as long-term published outcomes documenting complete excision of Stage IV disease — including the 32 cm endometrioma sent home the same day.
The worldwide hospital literature treats masses at 6 inches and larger as inpatient surgery. CIGC has performed 28 such cases and sent every patient home the same day from a freestanding surgery center.
Patients who were told their only option was open surgery — or to live with the pain
“I had a large 19 cm mass (8 inches) on my left ovary. The GYN in my home town wanted to cut me. It ended up being Stage IV endometriosis and CIGC removed it laparoscopically. I was up and walking, my incisions barely noticeable. I traveled from Michigan and I feel like myself again.”
“I over-research everything. When I needed surgery for Stage IV endo I read all of the CIGC published papers. These surgeons have the lowest complication rates anywhere. Don’t have your regular OBGYN do your surgery. Hands down, the best.”
“My first surgery, with my OB/GYN, took over 5 hours and he didn’t finish. My surgery at CIGC was 1 hour, back to work in a week. I wish I had found them years earlier.”
“I had been suffering for years. Moved from IL to MD — saved my life. I went through 4 prior surgeries for severe endometriosis and adenomyosis that were damaging other organs. I can honestly say I have not felt this great in years.”
“I had been suffering for many years. Due to endometriosis I had abdominal ascites — I looked 4 months pregnant. After searching for months I made an appointment with CIGC. After surgery I feel like a new person.”
“I had a surgery to remove an ovarian endometrioma which grew to 6–7 cm and a fibroid. After several months of pain I came across CIGC from the UK. Two days after surgery I was visiting Washington DC. Five days later I flew back to the UK. I am really very grateful.”
Patient testimonials reflect individual experiences; individual results vary.
The peer-reviewed evidence behind the outcomes
Every clinical claim on this page is sourced from peer-reviewed, PubMed-indexed publications. CIGC does not publish marketing claims; it publishes data.
A Retroperitoneal Approach to Endometriosis Excisions: Surgical Outcomes and Seven-Year Follow-up
Seven-year follow-up on RET outcomes for complete endometriosis excision — including Stage IV disease on bowel, bladder, ureters, and diaphragm. All cases same-day discharge from a freestanding surgery center. Longest published outcome record for endometriosis excision at a freestanding ASC.
Prevalence and Risk Factors of Coexisting Endometriosis in Women Undergoing LAAM for Symptomatic Leiomyoma and Subfertility
CIGC study documenting the prevalence of coexisting endometriosis in fibroid patients undergoing LAAM myomectomy, risk factors for concurrent disease, and fertility considerations. Full citation to be inserted upon publication.
Second opinion matters. Patients with persistent pain, normal imaging, failed prior surgery, or suspected Stage III/IV disease deserve evaluation by a specialist trained to remove disease from bowel, bladder, ureter, and pelvic sidewall when needed.
Schedule Your CIGC Surgical Consultation
Your case will be reviewed by Dr. Danilyants or a member of the CIGC surgical team to determine the best treatment plan for your specific situation.
We review your imaging, your surgical history, and your goals. We explain what is possible at CIGC — specifically and honestly — and what it will cost using your insurance. Consultations in Rockville, MD · Reston, VA · Secaucus, NJ · Telehealth.
Thank you — we’ve received your request.
A member of the CIGC surgical team will review your information and reach out shortly. For immediate assistance, call 1-888-SURGERY.
Monday – Friday, 8 am – 5 pm ET · Rockville, MD · Reston, VA · Secaucus, NJ