Minimally Invasive Deep Endometriosis Excision: The Gold Standard

Laparoscopic deep endometriosis excision surgery is the gold standard.

doctor will see you now

It is common for women with pelvic pain due to endometriosis to have their complaints ignored, and symptoms dismissed as normal period pain.

Confusion in the medical field about the appropriate way to handle endometriosis can actually make the condition worse. Women who suffer with endometriosis have to wait on average 7-10 years before getting a proper diagnosis, and by then, the disease can ravage the reproductive system, as well as other delicate structures in the pelvic cavity. There is no cure for endometriosis, and most women undergoing a hysterectomy will still experience pain.

The Doctor Will See You Now, Recognizing and Treating Endometriosis is a new book by Tamer Seckin, MD, founder of the Endometriosis Foundation of America. This patient-friendly overview of endometriosis, diagnosis, treatment, and accounts of Dr. Seckin’s patients, is an easy-to-read resource that navigates a complex condition not well understood by the medical community at large.

The diagnosis for endometriosis can only be made definitively through a laparoscopic procedure. Ultrasounds and MRIs cannot detect endometriosis. Since the diagnosis can only be made through what is considered by many doctors as an invasive procedure, it is common for doctors to try to rule out other conditions that mimic endometriosis, but this contributes to the delay in treatment.

GYN specialists who focus on endometriosis have seen thousands of women suffering from this disease, and have better methods for arriving at a preliminary diagnosis before confirming with a laparoscopic procedure. During that procedure, it is also appropriate for the surgeon to perform deep endometriosis excision, removal of the lesions formed by the disease.

From NIH: “The gold standard for the diagnosis of endometriosis has been visual inspection by laparoscopy, preferably with histological confirmation. Because there is no good noninvasive test for endometriosis, there is often a significant delay in diagnosis of this disease. Imaging that confirms an endometriotic cyst or deep infiltrating endometriosis may help guide surgical therapeutic approaches. …”

lakshmi and seckin


“To those affected in any way by endometriosis: I know the pain you’ve been battling. You hurt, a lot, more than anyone else can comprehend. You feel alone and hopeless. You’re physically and mentally drained, nearing your breaking point, if you haven’t reached it already. You’ve tried for years to get someone, anyone, to listen to you, to understand what you’re going through-a friend, a family member, a school nurse, even a doctor-but they don’t. They dismiss your issue as a “girl problem” or a “woman thing,” as a disease or condition that it’s not, or as something that will magically fix itself over time. They couldn’t be more wrong; you know it in your gut, and I know it for a fact. I know it, not due to experiencing this pain myself, but because I was taught by listening to my patients.” – Tamer Seckin, MD; The Doctor Will See You Now


The Center for Innovative GYN Care is dedicated to providing information and materials for women to help navigate the complicated healthcare system. Our minimally invasive surgical specialists have seen firsthand the pain and anxiety women with endometriosis face before getting a proper diagnosis, evaluation and treatment. We seen what delaying a diagnosis, or poorly performed surgery can do to a woman. The longer a woman suffers with endometriosis, the likelihood of extensive damage to the organs in her pelvic cavity increases due to inflammation and scarring. It is a sad fact for many women with endometriosis that fertility can be compromised.


Minimally invasive GYN specialists who understand endometriosis are less common than OB/GYNs. Women tend to have relationships with their OB/GYNs and assume that these doctors are specialists. The primary focus of an OB/GYN is obstetrics, with a very small percentage of their practice devoted to other GYN surgery.

For the most thorough removal of endometriosis, women must seek an expert in minimally invasive deep endometriosis excision. It is important for the procedure to be done thoroughly by an skilled specialist in laparoscopic excision, as well as bladder, bowel and ureter repair, since endometriosis can spread throughout the pelvis affecting more than the reproductive system.

CIGC minimally invasive GYN surgical specialists Dr. Paul MacKoul and Dr. Natalya Danilyants developed techniques to perform endometriosis excision or resection using only two 5MM incisions. Using DualPortGYN, our surgeons can thoroughly remove all endometriotic implants and lesions in an outpatient setting


GYN surgical specialists can often see women sooner because they are focused entirely on surgery. Each patient gets detailed, in depth attention from Dr. Natalya Danilyants and Dr. Paul J. MacKoul. This personalized care helps patients understand their condition and the recommended treatment so that they can have confidence from the very start. Our surgeons have performed over 20,000 GYN procedures and are constantly finding better ways to improve outcomes for patients.

Book a consultation today with Paul MacKoul MD or Natalya Danilyants MD.

Offices are conveniently located throughout the Washington D.C. area in Rockville, Reston, and Annapolis, MD. Women looking for a GYN specialist for a laparoscopic hysterectomy, endometriosis excision or fibroid removal travel to CIGC from around the world.


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deep endometriosis excision

Even if you are not from the DC area, many patients travel to The Center for Innovative GYN Care for our groundbreaking procedures. We treat women from around the world who suffer from complex GYN conditions.

Learn more in our travel program.


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