The fallopian tubes carry an egg from the ovary to the uterus and run along the top border of the ovary on a thin membrane called the mesosalpinx. In patients with severe endometriosis the fallopian tubes may be very difficult to identify; often the ovary and tube can be caught up within a mass of adhesions.
Surgery to restore tubal anatomy by laparoscopy is often undertaken in patients with large endometriomas (see ovarian endometriosis, above). It is rare to see endometriosis invading all the way through a fallopian tube. Careful removal of any mass is often undertaken by Dr Gordon while primarily addressing concerns for fertility.
In some circumstances, where a fallopian tube has been damaged by the disease (or by infection) for a long period of time, the only possibility to improve fertility is to remove the affected fallopian tube. In rare circumstances, removal of both fallopian tubes may be advisable. These patients will still be able to conceive, but only with the assistance of IVF.