Upcoming consultant appt...advice needed

Hi everyone just needed some advice.i have my consultation appointments next Tuesday and I'm hoping at this appointment he will discuss plan of care I:e findings from recent MRI.Has anybody got any tips at what I should be asking him at this appointment.I was informed by someone that this particular surgeon uses the process of diathermy (I don't know what it is and how this differs from an excision). I am nervous as I'm scared of the findings of the MRI. If on the MRI they find something is a diagnostic laparoscopy still necessary or can they straight excise the endo instead.

5 Replies

  • Hi - from your previous posts it seems you are being seen in a BSGE centre. They wouldn't do an MRI unless they suspect severe/infiltrating endo and this must be excised as a condition of working in an accredited centre. If they have seen evidence of deep disease on the MRI they will have an idea of what is involved and should get all the surgical team together to plan the main surgery and I imagine this is what they will be discussing with you. I should take a copy of the NHS contract with you (and read it well a few times first so you understand exactly what they should be doing). If they say they won't be excising your endo then they will be in breach of the contract in which case you should look for another centre. I don't think this will be the case though but if it is can you private messagae me as this would need taking up with the BSGE. 


  • Hi thank you for your reply.i will definetly pm you after my appointment if they do not excise the endo.do you know why diathermy should not be used? 

  • Several reasons. It uses a heat source and only 'burns' the surface. This means that they cannot then tell if there was any endo underneath that was not destroyed. It also means that the endo cannot be sent to pathology to confirm the diagnosis and also because heat conducts it can pass through to healthy tissue and damage or destroy it which can have severe consequences for ongoing pain and complications if we are talking about delicate structures like nerves, blood vessels or the ureters. You don't want to get to a point of coming back to report that they didn't use excision as it will be too late them. You must ensure it beforehand. x 

  • Hi Cabs. Lindle is correct. Have a Google to read about the difference in outcomes between diathermy and excision. Excision is the nearest thing you get to permanent removal of the spots of endo. Diathermy won't remove deep endo. I've had both; diathermy first time then 3 years later excision to remove the deep endo which the laser didn't reach. Excision was life-changing for me- in a good way. But, like Lindle says, you absolutely need to know what they are doing before the surgery. It should be excision if it's deep endo- it's best practice. 

  • Thank you ladies for your replies it's been really helpful and comforting to know.

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