Should I see a gyn, MIGS surgeon, or excision specialist for endometriosis?

If your goal is a routine evaluation, medication options, or basic pelvic surgery, a general gynecologist may be a reasonable starting point. The limitation is that most OB-GYNs have limited training in accurate diagnosis and complex excision. They often default to burning lesions (ablation/fulguration) or focus primarily on medical suppression, approaches that can miss deeper disease and sometimes lead to repeat surgeries.

A MIGS surgeon typically has stronger minimally invasive training and may be more likely to perform advanced laparoscopy/robotic surgery, which can matter for safety and recovery. That said, MIGS doesn’t automatically mean deep endometriosis excision expertise, especially when disease involves or may involve the bowel, bladder, ureters, pelvic nerves, or even the diaphragm. The extent of endometriosis training, as compared with broader minimally invasive gynecologic surgery (MIGS) training, and expertise vary.

If you suspect complex disease, have severe symptoms, prior surgery with persistent pain, endometriomas, adenomyosis concerns, or symptoms that suggest multi-organ involvement, you may want to explore your options further. Seeking an endometriosis excision specialist, who should always be a MIGS surgeon but also focuses on endometriosis, is usually the most direct path to thorough evaluation and a surgical plan designed for complete, anatomy-preserving removal when indicated. The goal is meticulous and macro-complete excision (often leveraging robotic 3D precision), with preparedness for the full range of findings, including coordinated multi-specialty support when needed. You can explore the Lotus approach and reach out to schedule a consultation to discuss what level of care best fits your case.