The most common kind of endometriosis surgery uses a method called fulguration, in which the endometriosis lesions are burned with a cautery device. This method of treatment could be compared to melting the tip of an iceberg, since much of the time, endometriosis is left under the surface of pelvic tissues. As a result, women who have an endometriosis fulguration procedure have a much higher chance of their endometriosis returning within 1-2 years after surgery.
A much more effective way of treating endometriosis is using a technique called excision, in which all endometriosis implants (and associated scar tissue and inflammation) are completely removed. This method of treating endometriosis results in a much lower chance of endometriosis returning after surgery (about 10-20%) and also results in better pain resolution compared with fulguration.