QC: Burning Questions, When or If Ablation Works

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Dr. Jeff Arrington, a renowned excision specialist and patient advocate, shares his expert perspective on when ablation might be appropriate in endometriosis treatment. He discusses the nuanced decision-making process that balances complete disease removal against fertility preservation, challenging the notion that excision is always the only acceptable approach.

• Small, superficial lesions could potentially be fully destroyed by ablation, though with more surrounding tissue damage
• When endometriosis grows around blood vessels to ovaries or the uterus, ablation may be used to preserve fertility
• Patient priorities, especially fertility concerns, should guide treatment approach decisions
• Ablation is ineffective for deeply invasive disease, especially on major organs
• Informed consent allows patients to understand risks and benefits of different approaches

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Episode Transcript

Speaker 1 (00:00):
Life moves fast and so should the answers to your
biggest questions.
Welcome to EndoBattery's QuickConnect, your direct line to
expert insights.
Short, powerful and right tothe point.
You send in the questions, Ibring in the experts and in just
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No long episodes, no extra timeneeded, and just remember

(00:20):
expert opinions shared here arefor general information and not
for personalized medical advice.
Always consult your providerfor your case-specific guidance.
Got a question?
Send it in and let's quicklyget you the answers.
I'm your host, alana, and it'stime to connect.

(00:44):
Today I have an incredibleexpert joining us Dr Jeff
Arrington.
If you've spent any time in theendometriosis community, you've
probably heard his name.
Dr Arrington isn't just anexcision specialist.
He's a fierce advocate forinformed consent and breaking
down the barriers that keep somany from accessing proper
endometriosis care.
His passion goes beyond theoperating room.

(01:04):
He's fighting for real change,pushing back against
misinformation and making surethat patients have the knowledge
and options they deserve.
Let's dive in.
Are there any instances whereablation is used and is
effective?

Speaker 2 (01:18):
I would have to say yes, you know, and I don't burn
small superficial lesions, but Imean there are some areas.
Say there's one or two littlespots.
In theory I think that it couldbe fully, you know, burned
enough to where that lesion isfully destroyed.
Now it is going to create morethermal damage or heat damage to

(01:41):
the surrounding tissue maybethan what excision would be
damage or heat damage to thesurrounding tissue maybe than
what excision would be.
And the question comes you knowwhat's more damaging or what's
worse?
You know, a big area of burnedtissue versus an area of raw
tissue that will heal over?
In my practice there are someinstances where I do ablation
and the main thing when apatient comes in with advanced
disease, infertility is thehighest priority.
I let them know that we'regoing in with.

(02:03):
You know, my goal is to removeall of the endo.
But if I find endometriosisthat's growing really tightly
around blood vessels to an ovaryor blood vessels to the uterus,
things of that nature, and myfirst attempt is to try to
separate the disease from those,but if I can't get it separated
without putting the organ atrisk, then I will back off and

(02:24):
treat those spots moreconservatively with trying to
burn the disease rather thancutting it, because I don't want
to risk the fertility of thepatient.
So those typically come intoplay when, at least in my
practice, where fertility is thehighest priority and going
after the disease with completeexcision really would increase

(02:45):
the risk of losing an ovary or auterus.
And you know the patient getsto decide if that's the
appropriate time for that or not.

Speaker 1 (02:53):
Yeah, do you do ablation on major organs if you
don't have a specialist in theOR with you?

Speaker 2 (03:02):
No, I mean most of the major organ type stuff I can
take care of on my own.
Anyways, I use excision onthose.
Truthfully, if the disease isbad enough that you would need
another specialist to come in,ablation is going to do
absolutely nothing for it,Because that to me, by
definition that means it'sdeeply invasive disease and

(03:23):
burning across the surface isgoing to do absolutely nothing.

Speaker 1 (03:27):
That makes sense.
That's a wrap for this QuickConnect.
I hope today's insights helpedyou move forward with more
clarity and confidence.
Do you have more questions?
Keep them coming, send them inand I'll bring you the expert
answers.
You can send them in by usingthe link in the top of the
description of this podcastepisode or by emailing contact

(03:47):
at endobatterycom or visitingthe endobatterycom contact page.
Until next time, keep feelingempowered through knowledge.