hi , salam, namaskar, sasriakal everyone,
My wife is diagnosed with C-Section Scar Endometriosis (in abs muscle beneath the C-Section stitches) via Ultrasound recently after our general physician recommended to get the scan during the cycle. After doing quick online research, we went for doctor consultation with Dr. Ramesh B. since there is unbearable pain which since last 3 months has become chronic (earlier it was only during and around periods). He has recommended to go for surgery which will involve a small laproscopic hole to inspect the Endometriosis and an open surgery where the extra tissue will itself be removed. He prescribed some pain killers to overcome the pain which my wife refuses to take to avoid any side effects.
- The tissue is to be removed with margins to avoid recurrence (need a gynaecologist who is well versed with tissue removal with margins).
- The rectus muscle if becomes lean would require mesh repair which falls under the scope of a hernia surgeon or general surgeon.
Here are the case details:
- Age: Below 30, Female, Bangalore, 1 kid of 3 years 8 months.
- Location: Bangalore
- Lesion: 6 cm x 1.1 cm x 0.9 cm heteroechoic lesion in the left lower rectus abdominis muscle — confirmed as scar endometriosis due to improper C-Section. Doctor confirmed it is 4 cm actually on physical examination.
- No intraperitoneal extension — lesion is entirely within the abdominal wall muscle.
- Open to travelling to Mumbai if the best option is there.
- Goal: Standalone endometriosis excision surgery by hands of best doctor who has performed similar cases of extra-pelvic endometriosis (outside pelvis and not the Doctor with experience of only pelvic endometriosis i.e. pelvis, uterus, ovary, etc.).
Key thing to note: This is NOT pelvic endometriosis — it is a rectus muscle / abdominal wall lesion. The surgery needed is open excision of the muscle lesion (possibly with mesh repair if defect is large), not laparoscopic pelvic surgery.
I am confused between these options:
- Dr. Ramesh B — Altius Hospital, Kalyan Nagar, Bangalore
- Very experienced broad laparoscopic gynaecologic surgeon
- Hospital has dedicated endometriosis department
- Concern: Reddit suggests he is primarily a laparoscopic surgeon, not a dedicated endometriosis specialist. Also there is self-promotion ads campaign by Altius Hospital promoting for Best Endometriosis Specialist.
- Dr. Sunil Eshwar — Aster RV Hospital, JP Nagar, Bangalore
- Good independent reputation for endometriosis on Reddit
- Concern: His expertise seems to be laparoscopic pelvic endometriosis — not sure if he handles rectus muscle / abdominal wall cases
- Dr. Jay Mehta — visiting Shanthi Gynec, Jayanagar (or Mumbai)
- India's highest-volume endometriosis surgeon
- Concern: His core expertise is Deep Infiltrating / pelvic endometriosis (bowel, bladder) — not sure if rectus abdominis cases are within his wheelhouse
- Also: Follow-up after Mumbai surgery would be difficult
- Manipal Hospital HAL — multidisciplinary team (Gynaecology + General Surgery)
- Large hospital with both departments — relevant since mesh repair may be needed
- Concern: Not sure if they have experience with this specific type of case, and worried about recurrence risk if margins are not clean
My specific questions:
- Has anyone had rectus abdominis / abdominal wall endometriosis surgery specifically (not pelvic endo) in Bangalore or Mumbai? Who did your surgery?
- Among the 4 options above, who would you recommend for this specific extra-pelvic case?
- Any experience with Manipal HAL's gynaecology + general surgery joint approach for complex cases?
- Is there any other surgeon in Bangalore or Mumbai specifically experienced in abdominal wall endometriosis excision, whom I can consider for surgery?
- Should I opt for a surgeon who can handle both the tissue excision and mesh repair or go for big hospital like Manipal where multiple surgeons can be involved (needs planning by multiple surgeons before surgery).
Due to the unbearable pain which also feels like it is bleeding internally, we want to go for surgery (next month between 9th May and 13th May 2026.)
Any help is deeply appreciated. Happy to share ultrasound report details in DM if helpful.
Flair: Endometriosis Surgery advice / Doctor recommendation / Bangalore / Mumbai