PEARS (Pelvic Excision And Repair Surgery)

PEARS is a form of pelvic surgery that removes disease and rebuilds normal anatomy. The letters stand for pelvic excision and repair surgery. Some NaProTechnology sources write the R as reconstructive. Both names describe the same operation. Dr. Thomas W. Hilgers developed it at the Pope Paul VI Institute.¹ PEARS resembles plastic surgery of the pelvis.

A PEARS surgeon cuts endometriosis out (excision) rather than burning it away (ablation). Burning destroys only the surface of a lesion. Excision removes the whole lesion, including its base. Disease that is only masked keeps growing. Disease that is removed is gone.²

Removing the disease is half of the operation. The repair half aims to prevent scar tissue (adhesions) from forming. The surgeon closes the lining of the pelvis and the surface of the ovary with fine stitches. The surgeon turns the rough edges inward. As a result, only smooth tissue faces the open pelvis. Gentle rinsing and soft barriers keep raw surfaces apart while they heal. This repair matters because scar tissue after pelvic surgery is a leading cause of later infertility.

Surgeons use PEARS across a wide range of pelvic disease. This range includes endometriosis on the lining of the pelvis, ovarian cysts of endometriosis (endometriomas), and ovaries affected by polycystic ovary syndrome (PCOS, now renamed PMOS). It also includes fibroids, damaged fallopian tubes, and scar tissue.¹ The goal is to restore normal anatomy so that a couple can conceive naturally. Pain relief follows once the disease is gone.