Concierge gynaecology · London
Excision surgery for endometriosis, at a BSGE-accredited centre.
Laparoscopic — increasingly robotic — excision of endometriotic implants and deep infiltrating disease. Not ablation. With colorectal and urology on the same list when the disease demands it.
Why patients choose us
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A BSGE-accredited surgeon, not a general list
Deep infiltrating endometriosis needs a British Society for Gynaecological Endoscopy centre — gynae, colorectal and urology in one theatre. We only introduce surgeons who work there.
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Excision, not ablation, where it matters
For deep disease and endometrioma, we back excision over ablation — the evidence and NICE NG73 point the same way. Ablation has a place; we say when.
- 03
Independent, and free
We are paid by no clinic, so the recommendation — surgeon, centre, timing, fertility plan — is impartial and costs you nothing.
Indicative pricing
What private excision surgery for endometriosis costs in London.
Indicative ranges across our partner clinics and BSGE-accredited centres. Send the details and we quote firm figures across two or three options.
In short
BSGE-centre excision for deep disease in our network: £15,000–£28,000, home in 1–3 nights.
| Procedure | Indicative range | Typical duration | Recovery |
|---|---|---|---|
| Consultant gynaecology consultation | £250–£450 | 30–45 min | Same visit |
| Specialist TVUS + MRI mapping | £800–£1,600 | 1–2 visits | 3–7 days |
| Diagnostic laparoscopy ± superficial excision | £4,500–£7,500 | 60–90 min GA | Day-case |
| Laparoscopic excision — moderate disease | £8,000–£14,000 | 2–3 h GA | 0–1 night |
| BSGE-centre excision for deep DIE (multidisciplinary) | £15,000–£28,000 | 3–6 h GA | 1–3 nights |
| Segmental bowel resection for rectal DIE | £22,000–£38,000 | 4–6 h GA | 3–5 nights |
Prices vary by centre, by the extent of disease found on the day, and by whether colorectal or urology work is added. We come back with a firm quote within one working day.
The problem
The right centre, the right surgeon, the right technique.
Deep infiltrating endometriosis is quietly one of the most poorly booked operations in the private market — wrong centre, ablation instead of excision, and no colorectal or urology in the room. We fix all three before you consent.
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Not sure it is deep disease?
A specialist scan and MRI decide. A general unit is fine for superficial disease — a BSGE centre is not.
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Worried about ovarian reserve?
We check AMH first, plan the endometrioma technique to preserve it, and involve fertility specialists early.
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Want it done properly?
A named BSGE-accredited consultant, robotic where it helps, and colorectal/urology on the same list.
The journey
From enquiry to recovery — what happens, in order.
One clinician from first message to review — including the hormonal plan afterwards.
Phase 1 · Before your surgery
Concierge, off-stage for you
Phase 2 · On the day
Day-case or 1–3 nights
Phase 3 · After
Concierge, back on
- 01
Before
You tell us what is going on
A short, confidential form. Symptoms, cycle pattern, prior scans or laparoscopies, fertility plans.
- 02
Before
We map the disease before theatre
Specialist transvaginal ultrasound and pelvic MRI to map deep infiltrating endometriosis — bowel, bladder, ureters, diaphragm — before anyone picks up a scalpel.
- 03
Before
We match you to the right centre
Superficial disease can be handled in a good general unit. Deep or bowel/urinary disease goes to a BSGE-accredited severe endometriosis centre. We say which, and why.
- 04
On the day
Admission and pre-op
Consent with the consultant, anaesthetic assessment, VTE prophylaxis, and — where advised — a light bowel preparation the day before.
- 05
On the day
The operation itself
Laparoscopic (increasingly robotic) excision of implants and deep nodules under GA. Bowel, ureter or bladder work is done by the relevant specialist in the same theatre.
- 06
On the day
Recovery and discharge
Simple excision is often day-case; complex DIE stays one to two nights on an enhanced recovery pathway. Home when eating, mobilising and pain-controlled.
- 07
After
Follow-up and hormonal maintenance
Two to six weeks off, review with the consultant, and a hormonal plan (Mirena, dienogest, COCP) to cut recurrence — unless you are trying to conceive.
Typical end-to-end: 4–6 weeks from enquiry to surgery. Full healing: 2–8 weeks by extent of disease.
When it helps
When excision surgery is the right step.
The situations we see most, plus the one red flag that means an emergency rather than an appointment.
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Cyclical pelvic pain not settling on medical therapy
Pain that persists despite the pill, progestogens or GnRH — a signal that surgical excision may add what medication cannot.
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Deep infiltrating endometriosis (DIE) on scan
Nodules on uterosacrals, rectovaginal septum, bowel, bladder or ureter — excision at a BSGE-accredited centre, not a general list.
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Endometrioma on the ovary
Chocolate cysts distorting the ovary — cystectomy (stripping) is preferred over drainage or ablation, with AMH checked first if fertility matters.
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Bowel symptoms with cycle
Cyclical rectal bleeding, painful bowel motions or tenesmus around periods — suspicion of bowel endometriosis and a colorectal opinion in theatre.
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Urinary symptoms with cycle
Cyclical haematuria, loin pain or a silently obstructed kidney — ureteric endometriosis needs urology alongside gynaecology.
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Subfertility with confirmed endometriosis
ESHRE evidence supports excision to improve natural pregnancy rates in wanting-fertility patients — weighed against IVF and against ovarian reserve.
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Recurrent disease after prior ablation
Symptoms returning after a previous ablation-only laparoscopy — a common reason to move to excision at a specialist centre.
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Red flag: acute obstruction
A silently obstructed kidney on scan or bowel obstruction with a known DIE nodule is urgent — hospital assessment the same day, not a clinic booking.
Procedure options
One operation, many named steps.
What each step of a full excision list actually involves — and which is relevant to which pattern of disease.
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Laparoscopic peritoneal excision
Cold-scissor or energy-device excision of superficial peritoneal implants — the workhorse for early-stage disease.
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Uterosacral ligament excision
Nodules on the uterosacral ligaments causing deep dyspareunia are excised at their base — a common step in DIE surgery.
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Ovarian cystectomy for endometrioma
The cyst wall is stripped (not drained or ablated) to reduce recurrence — technique matters for ovarian reserve.
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Rectal shaving or discoid excision
For rectal DIE that does not need a segmental resection — the nodule is shaved or a small disc removed, preserving bowel length.
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Segmental bowel resection
For full-thickness rectal DIE — a segment of rectum is removed and an anastomosis fashioned; a protective ileostomy is used in selected cases.
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Ureterolysis and ureteric reimplantation
The ureter is freed from disease; if the wall is involved, a partial ureterectomy and reimplantation into the bladder is performed by urology.
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Robotic (da Vinci Xi) excision
Wristed instruments and 3D vision for deep pelvic and rectovaginal dissection — increasingly used in BSGE centres for complex DIE.
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Diaphragmatic endometriosis excision
For shoulder-tip pain or cyclical chest symptoms with proven disease on the diaphragm — thoracic input where needed.
Our vetted London network
A small panel of BSGE surgeons, we picked them.
Consultant gynaecologists across BSGE-accredited severe endometriosis centres in London. Not listed publicly — introductions are made privately, once we understand your case.
Selection criteria
How we choose every surgeon in our network.
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BSGE-accredited severe endometriosis centres for deep infiltrating disease
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Consultant gynaecologists with a declared endometriosis subspecialty
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Colorectal and urology on the same operating list for bowel and ureteric DIE
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Fertility counselling and AMH testing offered before ovarian surgery
Safety and recovery
What to expect afterwards — honestly.
Excision surgery is highly effective, but the risks scale with the extent of disease. The choice of centre — and the completeness of the resection — matter more than any single technical detail.
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Bowel and ureteric injury
The main serious risks of DIE surgery. A BSGE-accredited centre with colorectal and urology on the list is the single biggest safety factor.
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Ovarian reserve after cystectomy
Stripping an endometrioma can reduce ovarian reserve. AMH is worth measuring first, and fertility options discussed before surgery if you are young.
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Recurrence is real
Roughly 10–15% recurrence at five years with hormonal cover after complete excision; up to 40% without. Incomplete resection is the single biggest predictor.
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Pain may persist even after complete excision
Chronic pelvic pain has a central-sensitisation component. Complete surgery helps most patients — but honest counselling matters up front.
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VTE and general laparoscopic risks
Deep vein thrombosis, port-site hernia, wound infection, PONV and shoulder-tip pain from gas — small individual risks, standard for a long laparoscopic case.
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Fertility outcomes
Pregnancy rates of around 50–70% are reported after excision in wanting-fertility patients — better than medical therapy alone per ESHRE, though not a guarantee.
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Recovery timelines
Two weeks for simple excision, four to six weeks for complex DIE, and up to eight weeks after bowel resection. Driving returns when you can perform an emergency stop pain-free.
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Hormonal maintenance
A Mirena, dienogest, POP or COCP is offered after surgery — unless you are trying to conceive — to suppress residual and microscopic disease.
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Red flags after discharge
Fever, spreading abdominal pain, heavy bleeding, inability to pass urine or a swelling calf are not normal — contact the on-call gynaecologist or A&E the same day.
Reading your operation note
Your operation note in four parts. Read the last one first.
Whether the case was straightforward or complex, the note the consultant sends you keeps to the same shape.
A quiet reminder
Surgical language is precise and can read coldly — we translate it for you.
If you would like us to talk you through the note before your review, just ask.
- 01 Header
Indication and disease map
Why surgery was done — pain, DIE, endometrioma, subfertility — and the pre-op map from TVUS and MRI.
- 02 Technique
Approach, energy sources and specialists involved
Laparoscopic or robotic, cold-scissor or energy device, and which colorectal or urology colleagues operated with the gynaecologist.
- 03 Findings
rASRM stage, sites treated, completeness of excision
The revised ASRM stage, every site treated, and — critically — whether excision was complete or residual disease remains.
- 04 Impression
Recovery, hormonal plan and fertility advice
Read this first: expected recovery, the hormonal plan to reduce recurrence, and any specific fertility guidance or referral.
Recognised by major UK insurers
Cover for excision surgery is usually funded when medically indicated. Some insurers require pre-authorisation for complex DIE and bowel resection. We confirm cover before booking.
Frequently asked
Everything we get asked about excision surgery for endometriosis.
Quick answers on centres, technique, cost, fertility and recurrence.
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Why excision rather than ablation for endometriosis?
Excision physically removes the disease and lets the pathologist confirm it; ablation burns the surface and can leave deeper disease behind. NICE NG73 and RCOG guidance support excision for deep infiltrating endometriosis and endometrioma. Ablation still has a place for very superficial peritoneal disease.
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What is a BSGE-accredited endometriosis centre?
A unit accredited by the British Society for Gynaecological Endoscopy to treat severe endometriosis, with a multidisciplinary team — gynaecology, colorectal, urology and specialist nursing — working from the same operating list. Any suspicion of deep infiltrating disease should be referred there.
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How is endometriosis mapped before surgery?
A specialist transvaginal ultrasound (with a sliding-sign check for rectovaginal disease) and a pelvic MRI. Together they map bowel, bladder, ureteric and diaphragmatic involvement so the right specialists are in theatre on the day.
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Will excision surgery affect my fertility?
For most patients excision improves fertility — reported pregnancy rates are roughly 50–70% in those trying to conceive after surgery, better than medical treatment alone per ESHRE. Ovarian cystectomy for endometrioma can reduce ovarian reserve, so AMH is worth measuring first if you are young.
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What happens if there is bowel endometriosis?
A colorectal surgeon works with the gynaecologist on the same list. Options are shaving, discoid excision or — for full-thickness rectal disease — a segmental bowel resection with anastomosis, sometimes with a temporary protective ileostomy.
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How much does private excision surgery cost in London?
Diagnostic laparoscopy with superficial excision is roughly £4,500–£7,500. Moderate excision is £8,000–£14,000. BSGE-centre surgery for deep infiltrating disease is £15,000–£28,000, and a segmental bowel resection £22,000–£38,000. We come back with a firm quote within one working day.
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How long is recovery after excision?
Two weeks for simple excision, four to six weeks for complex deep infiltrating disease, and up to eight weeks after a bowel resection. Most people drive again in one to three weeks, once an emergency stop is pain-free.
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Will the pain come back after surgery?
With complete excision and post-op hormonal maintenance, recurrence at five years is roughly 10–15%. Without hormonal cover, it can reach 40%. Chronic pelvic pain has a central-sensitisation component that may persist even after a technically complete operation — honest counselling matters up front.
Related
Looking for something else?
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Endometriosis
The condition — diagnosis, medical and surgical options.
Learn more -
All tests and procedures
Every test and procedure we arrange.
Learn more -
Pelvic MRI
The mapping scan before endometriosis surgery.
Learn more -
Fertility assessment
AMH, reserve and fertility options before surgery.
Learn more