Will endometriosis excision surgery need bowel resection or a stoma?

Most endometriosis excision surgeries do not require a bowel resection, and a stoma is uncommon. Those possibilities come up mainly when endometriosis is deeply infiltrating the bowel wall (most often the rectum or sigmoid) or when scar tissue has significantly distorted anatomy. Many patients with “bowel symptoms” actually have inflammation and irritation around the bowel without true full-thickness bowel disease, which can often be treated without removing a segment of bowel.

When bowel endometriosis is present, there’s a spectrum of surgical options—from carefully peeling disease off the bowel surface, to a full-thickness disc excision, to a segmental resection when the lesion is deep, extensive, or narrows the bowel. Our team plans this in advance as much as possible using your symptoms, exam, and imaging to map disease and decide whether a colorectal surgeon should be involved on the day of surgery.

If you’re worried about waking up with a stoma, that’s exactly the kind of risk discussion we have clearly before surgery—based on what we see on imaging and what we suspect we’ll find. In a consult, we’ll walk you through the likely bowel scenarios for your specific case and how robotic excision helps us be precise and tissue-sparing while still prioritizing safety.