16/10/2026
THE FIRST SURGERY SHOULD BE THE LAST SURGERY.
I see far too many women in my clinic who have undergone two, three, four or even more operations for endometriosis.
Why have we come to accept repeated surgery as normal?
I strongly believe this needs to change.
The first operation is the most important operation.
It should never be an unplanned procedure, carried out without adequate assessment, appropriate imaging, multidisciplinary discussion or the right surgical expertise.
Before entering the operating theatre, we should know what disease we are dealing with, where it is likely to be, what needs to be removed and which specialists may be required.
That means proper preoperative assessment, expert ultrasound, MRI where indicated, and multidisciplinary team (MDT) planning for complex disease.
I believe in meticulous, precise and complete excision of visible endometriosis where safely achievable — not simply burning a few patches and leaving the deeper disease behind.
Diagnostic laparoscopy should not be a routine first step when appropriate non-invasive assessment and a properly planned treatment pathway are available.
Whether in the NHS or private sector, the standard should be the same.
Of course, some women will need further surgery. Even some of my own patients do.
But repeat surgery should be the exception, not the expectation.
We cannot promise that endometriosis will never return. But we can give every woman the best possible chance of avoiding another operation.
And that responsibility begins long before the first incision.
My message is simple:
Plan the first surgery as though it must be the last.
Because women deserve more than a cycle of repeated operations.
They deserve a properly planned operation, the right expertise and a long-term care plan.
