Endometriosis Surgeon Selection Checklist

Before the appointment

• [ ] Symptom timeline written down (onset, pattern, cycle relationship, severity)
• [ ] Prior imaging on CD/DVD or portal access
• [ ] Prior operative and pathology reports
• [ ] Current and past medications, including hormonal therapy
• [ ] List of prior treatments tried and results
• [ ] Fertility goals clarified (now, later, uncertain, not applicable)
• [ ] Support person available to take notes

Surgeon experience

• [ ] Do you primarily perform excision, not only ablation?
• [ ] How many endometriosis cases per year?
• [ ] Experience with deep infiltrating endometriosis specifically?
• [ ] Fellowship or dedicated endometriosis training?
• [ ] Do you publish or teach in endometriosis surgery?
• [ ] Robotic assistance available when appropriate?

Multidisciplinary readiness

• [ ] Colorectal surgeon available in the same operating room for bowel disease
• [ ] Urology / urogynecology available for bladder or ureter disease
• [ ] Fertility specialist coordination when pregnancy is a goal
• [ ] Pelvic floor physical therapy and pain support
• [ ] Neuropelveology available for nerve-related pelvic pain
• [ ] Nutrition and psychological support offered

Imaging and pathology

• [ ] Expert MRI or specialized mapping ultrasound reviewed pre-op
• [ ] Imaging read by a radiologist experienced with endometriosis
• [ ] All removed tissue sent to pathology
• [ ] Pathology and operative reports shared with me and my home physician

Consent and planning

• [ ] Risks, benefits, and alternatives discussed in plain language
• [ ] Written plan if disease is more extensive than expected
• [ ] Discussion of what will and will not be treated at this operation
• [ ] Explanation of hormonal therapy after surgery (if applicable)
• [ ] Nerve-preserving technique discussed if deep disease is present
• [ ] Ovarian reserve considered if fertility is a goal

Cost and logistics

• [ ] All fees disclosed in writing (surgeon, anesthesia, hospital, imaging, pathology)
• [ ] Package inclusions and exclusions confirmed in writing (if applicable)
• [ ] Insurance verification or self-pay estimate
• [ ] Travel timeline and clearance-to-fly guidance (if traveling)

Complications and follow-up

• [ ] Complication management protocol explained
• [ ] 24-hour contact for post-op concerns
• [ ] Number and format of follow-up visits (in person or video)
• [ ] Length of follow-up coverage included
• [ ] Coordination with home OB-GYN or primary care
• [ ] Recurrence monitoring plan

Red flags to reconsider

• [ ] Guaranteed cure, pain relief, or pregnancy claims
• [ ] No imaging plan for a complex case
• [ ] Refusal to name pathology or multidisciplinary backup
• [ ] Pressure to schedule same day
• [ ] Reluctance to answer specific volume or technique questions

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