11/08/2026
What happens when a routine hysterectomy becomes a completely different surgery?
Sometimes, the biggest challenge in complex endometriosis surgery isn’t knowing how to operate.
It is knowing when to pause.
A planned hysterectomy for fibroids may unexpectedly reveal a frozen pelvis with deep infiltrating endometriosis involving structures such as the bowel, bladder or ureters.
At that point, the surgical plan needs to be reconsidered carefully.
The latest edition of Endometriosis Weekly focuses on the critical decisions that follow an unexpected intraoperative finding:
→ Stop routine dissection and systematically survey the pelvis.
→ Reassess the limits of the patient’s consent.
→ Consider whether the surgeon has the required expertise.
→ Assess whether the appropriate multidisciplinary team is available.
→ Put the patient’s long-term outcome ahead of completing the operation at all costs.
→ Document the findings and communicate the plan clearly.
Because deep endometriosis is not simply a routine hysterectomy with a few additional steps.
Sometimes, the safest surgery is the surgery you decide not to perform that day.
Read the latest Endometriosis Weekly: “The Pelvis You Didn’t Order” — a practical discussion on surgical judgement, patient safety, consent and managing the unexpected frozen pelvis.