Specialized endometriosis excision surgeons focused on complex endometriosis

Advanced Endometriosis Excision Specialists in Bethesda

At PRM, we proudly extend our specialized care for endometriosis to the Bethesda community. Located in the Bethesda area, Dr. Evan Friedman is a highly sought-after excision surgeon known for his expertise in providing exceptional care for endometriosis.

The PRM Center of Excellence (COE) is the only endometriosis center in the nation offering lifetime, integrated care for the complex inflammation and comorbidities of endometriosis. Our three-step approach represents the future of pelvic pain management, designed to reduce the number of surgeries patients may need over a lifetime.

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86%

of PRM surgery patients experienced a 51% decrease in their pain post-op.

67%

reduction in emergency room visits by PRM surgery patients following their excision.

39%

reduction in emergency room visits by PRM surgery patients following their excision

Why Excision Is The Gold Standard for Severe Endometriosis

Endometriosis is definitively diagnosed only when diseased tissue is visually identified and confirmed histologically, typically happening during surgery. While some surgical approaches use ablation or superficial techniques, excision removes deep, infiltrating endometriosis at the root of symptoms. This leads to more thorough relief, fewer repeat procedures, and better long-term outcomes.

At PRM’s Center of Excellence in Bethesda, our surgeon is MIGS fellowship-trained and exclusively focused on endometriosis excision surgery. A distinction few programs nationwide can claim. We believe patients deserve consistency, specialization, and expertise every time, not just occasionally.

Your Surgical Team In Bethesda

Meet Dr. Evan Friedman, MD: Focused on Complex Excision Cases

With a dedicated focus on women’s health and complex pelvic surgery, Dr. Evan Friedman brings precision, compassion, and advanced surgical skill to every patient. He is fellowship-trained in minimally invasive gynecologic surgery (MIGS) and specializes in the diagnosis and excision of deep and recurrent endometriosis — helping patients find real relief when other approaches have fallen short.

• Board-Certified OB/GYN
• MIGS fellowship trained
• Expertise in complex endometriosis and recurrent disease
• Personalized surgical planning

The majority of surgeries performed at our center are outpatient procedures, allowing patients to return home on the same day.

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This Is For Patients With Persistent or Severe Symptoms

We Know Endometriosis

Endometriosis Excision With PRM

Patients come to us after years of struggling with:

• Painful periods, pelvic pain & bloating
• Pain during intercourse
• Pain after prior laparoscopy or ablation
• Recurrence after surgery
• Symptoms that limit daily life

Many patients are told “everything looks normal,” yet the pain persists. This is common with deep infiltrating endometriosis, which often hides beneath healthy-looking tissue. Excision isn’t just surgery, it’s a deeper approach to diagnose and treat the disease thoroughly.

Complex Endo Consult Speak to a Specialist

Your Excision Surgery Journey - Step by Step

PRM's Surgical Process

Step One: The surgical procedure begins with approximately 3-4 tiny incisions on your abdomen below the umbilicus and a 10 mm incision inside the umbilicus. Carbon dioxide is used to inflate your abdomen, and the tiny camera and other surgical instruments will be placed through the incisions.

Step Two: The surgeon will then explore the abdomen and pelvis, looking for any endometriosis. If endometriosis is found, the lesions will be carefully excised with tiny surgical scissors and removed from the body to be sent to pathology.
The surgery may last 1-6 hours, depending on the extensiveness of the endometriosis and the amount to be excised.

Step Three: Upon completion of the procedure, the carbon dioxide and all instruments will be removed. The incisions on your abdomen will be closed with dissolvable stitches, the tube will be removed from your mouth, and you will wake up.

Step Four: In the recovery room and post-operative observation room. You will be carefully monitored for several hours. Typically, you will be discharged with instructions the same day or the next day after the surgery.

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Pain after surgery?

Endometriosis Can Return...But It Doesn’t Have To Stay That Way

Recurrence is not uncommon when disease is only superficially treated or partially removed. Many patients who undergo ablation or limited laparoscopy continue to experience symptoms because not all endometriosis is visible from the surface.

Our excision surgeons are trained to remove disease at depth, especially for:

• Persistent pain after a prior laparoscopy
• Recurrence of symptoms sooner than expected
• Lesions near vital pelvic structures
• Advanced or infiltrative disease patterns

When others say “nothing more to do”, we bring a deeper understanding and a more complete solution.

Ready to Find Answers? Start With an Expert Evaluation

We help patients when others fall short with compassionate, specialized, excision-focused care. Call us today to learn more about excision surgery for endometriosis at PRM’s Center of Excellence.

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Testimonials

NIKIA C.

Nikia C.

Was in a lot of pain with pelvic floor when I first started coming. Took me a while to get a diagnosis and to understand what was happening in my body. Dr. Zirolli and staff were very professional and took excellent care of me. The treatment plan worked , I highly recommend their services.