Ms B?bhinn Nic Liam:

Every case has to be dealt with on an individual basis and also having regard to the wishes of the patient. Excision surgery is more difficult and time-consuming and requires a really high skill level. We try to have everything evidence based and there is not quite enough evidence to say it is the only form, especially on more delicate areas such as the bladder, ureter and so on. We would welcome more research in that area. It can also be a very subjective thing in that the outcome of surgery is very dependent on the skill set of the surgeon and the complexity of the case. If the patient has been suffering with endometriosis for a long time, she could have a lot of scar tissue and multiple adhesions from multiple surgeries and so on. The location of endometriosis can be anywhere in the body. If the nerves are affected, it requires even more specialised surgery. As far as I know, there is only one person in Europe who will operate on endometriosis on the nerves.