Toolkit
Two operations, often named in the same sentence of the same report. The specific word tells you what was actually done to the tissue.
Excision removes the lesion along its tissue plane; ablation treats the visible surface. They're different techniques with different tradeoffs depending on what's found -- this is worth understanding, not a verdict on how your surgery went. If you're unsure why one was chosen, that's a good question for your surgeon.
Excision
The lesion was cut out, with the aim of removing its full depth.
Ablation, fulguration or cautery
The lesion was burned or destroyed at the surface rather than cut out.
Ovarian cystectomy
The wall of an ovarian cyst was stripped out of the ovary.
Cyst drainage only
The cyst was emptied but its lining was left behind.
Bowel shaving
Disease was shaved off the surface of the bowel without opening it.
Hysterectomy
The uterus was removed.
Ovarian reserve lives in the cortex — the outer layer. When an endometrioma wall is stripped out, the cleavage plane runs through that layer. This is why you may see notes about haemostasis technique or ovarian reserve in the report or the follow-up letter.
Emptying a cyst without removing its lining is a different procedure from cystectomy, and recurrence rates differ. Worth knowing which one your report describes.
Adenomyosis lives in the wall of the uterus, so removing the uterus removes it. Endometriosis lives outside the uterus, so removing the uterus does not remove it. If you had a hysterectomy and still have pain, that is a recognized outcome and not a sign that you imagined the pain or that the operation was botched.
Tissue sent to pathology can be confirmed by the classic triad: endometrial glands, stroma, and haemosiderin-laden macrophages. A lesion identified by eye and not sampled is a surgeon's judgment, which is a reasonable basis for treatment but a different kind of evidence. Both appear in reports and they are not interchangeable.
