Endometriosis Excision Surgeon
Dr. Traci E. Ito
San Francisco, California
At a Glance
Strengths
- Helps lead UCSF's multidisciplinary endometriosis center, with a focus on patient education and community outreach
- Directs robotic surgery training for UCSF's OB/GYN department and won a 2024 award for best robotic surgery video at a major international gynecologic surgery conference
- Brings in colorectal and urology surgeons for complex cases, with multiple accounts of a colorectal surgeon on standby or on the team
- A strong pattern of patients feeling heard, with several describing first appointments lasting over an hour
Worth Knowing
- Long waits. Multiple accounts describe 7 to 8 months between first appointment and surgery
- Reaching the surgeon between visits can be difficult. Multiple accounts describe frustration with scheduling staff and being routed to a nurse practitioner
From the Editor
Dr. Ito doesn't have a big public endometriosis presence online. There's no public social media, very little self-promotion, and only one published piece on endometriosis. What there is, though, is a wealth of reviews from endo patients over the past few years, and most of them are strongly positive. Patients repeatedly describe long first appointments and finally feeling heard. The main frustration patients describe is getting through UCSF's scheduling system, not the surgeon herself. For patients who want a surgeon inside a large academic center, with colorectal and urology support available, this surgeon might be a good fit.
Patient Feedback
Patterns Across Patient Feedback
Endometriosis Focus
Endometriosis as One Focus Within a Complex Gynecologic Surgery Practice
Dr. Ito is a gynecologist and minimally invasive gynecologic surgeon at UCSF Health in San Francisco. Her UCSF Health biography describes a practice built around complex pelvic conditions such as fibroids, pelvic pain, and large ovarian cysts, with a special focus on patients who have had multiple previous surgeries or have been treated by many providers before reaching her clinic. Endometriosis is not named in that biography, but it is listed among her areas of focus on her UCSF faculty profile. In a UCSF Health staff spotlight, Dr. Ito describes herself as one of the directors of UCSF's multidisciplinary endometriosis center, and a UCSF webinar introduced her as the center's coordinator of patient outreach. Patient accounts on Nancy's Nook and Reddit from 2023 through 2026 describe endometriosis surgery with Dr. Ito, including cases involving the bowel and bladder, and Nancy's Nook members refer to her as a Nook-recommended surgeon.
Dr. Ito completed residency in obstetrics and gynecology at George Washington University and a fellowship in minimally invasive gynecologic surgery at the University of Louisville under Dr. Resad Pasic. UCSF Health lists board certification from the American Board of Obstetrics and Gynecology in both obstetrics and gynecology and minimally invasive gynecologic surgery.
Surgical Method
Excision as the Primary Approach, Performed Robotically
Dr. Ito performs endometriosis surgery using excision, which means cutting out the diseased tissue rather than burning its surface. In a UCSF webinar, she explained that she removes each lesion along with a margin of normal surrounding tissue. Her stated reasons are that she was trained that excision controls symptoms better and delays recurrence, that it may capture microscopic disease nearby, and that it provides tissue for pathology (lab confirmation of the diagnosis), which burning does not. A 2024 Nancy's Nook account reports that Dr. Ito told the patient she primarily uses excision, but will use ablation (burning the tissue) when a spot is very small or in a risky location. Patient accounts on Healthgrades and Nancy's Nook describe surgery performed with the da Vinci robotic system.
Ask directly
- Do you perform excision, ablation, or both? What factors determine which approach you use?
- Do you use robotic or manual laparoscopy, and does that vary by case?
Other Areas of Specialty
Fibroids, Hysterectomy, and Complex Pelvic Surgery
Fibroids (noncancerous growths in the uterus) are a major part of Dr. Ito's practice. Her current research project focuses on controlling bleeding during fibroid surgery, and her published work includes a review of fibroid treatment options that avoid surgery and a study of minimally invasive hysterectomy for very large uteruses. Patient accounts also describe hysterectomy for adenomyosis (a condition where tissue similar to the uterine lining grows into the muscle wall of the uterus) and removal of large ovarian cysts and fibroids during endometriosis surgery.
Multidisciplinary Approach
Colorectal, Urology, and Pelvic Floor Support Within a Large Academic Center
In a UCSF webinar, Dr. Ito described UCSF as a major referral center and outlined when other surgical specialists join her cases. Colorectal surgeons may operate alongside her when endometriosis is suspected of growing into the bowel or when there is rectal bleeding, and may perform a colonoscopy to look at the inside of the bowel. General surgeons or gynecologic oncologists may help with extensive scar tissue around the bowel. Urologists may assist when the bladder or ureters (the tubes that carry urine from the kidneys to the bladder) are involved. She noted that she can remove the appendix herself, but may ask for help when it looks very abnormal. Patient accounts on Nancy's Nook and Reddit are consistent with this approach.
The same webinar featured a UCSF pelvic floor physical therapist describing how the PT team works with UCSF's endometriosis surgeons before and after surgery, and coordinates with gastroenterology, urology, pain management, and fertility care. For patients who want to understand their fertility options before surgery, Dr. Ito said she recommends a consultation with a fertility specialist.
Ask directly
- Do you recommend pelvic floor physical therapy as part of treatment, and do you have providers you refer to?
Diagnosis Methods
A Detailed History and Exam, With Imaging Used as a Guide
In a UCSF webinar on preparing for endometriosis surgery, Dr. Ito walked through her evaluation before surgery. It starts with a detailed history: when pain began, how it affects quality of life, bladder and bowel symptoms, and less typical signs such as cyclical leg pain, rib pain, trouble breathing during a period, or rectal bleeding during a cycle. She gathers previous imaging, surgical reports, pathology, and a record of past treatments and why they did not work. Her exam includes checking for tenderness, nodules (firm lumps that can signal deep endometriosis), and whether the uterus and nearby organs move freely, with a rectovaginal exam when appropriate and with consent. She said that when organs feel stuck, she relies on her clinical judgment and not just imaging.
She described ultrasound as a useful first test, looking for signs such as ovarian cysts caused by endometriosis or ovaries stuck behind the uterus, and MRI as the better test for deep endometriosis, suspected recurrence, and bladder or bowel symptoms. She stated that a negative MRI in a patient with a long history of pelvic pain is still taken seriously and does not take surgery off the table, and that a confirmed diagnosis comes from surgery and pathology. Patient accounts on Nancy's Nook and Reddit describe MRI as a routine part of her workup before surgery.
Educational Presence
Surgical Teaching and Institutional Outreach, With Little Personal Public Presence
No personal social media accounts or podcast appearances were found. Dr. Ito's public endometriosis content is produced through UCSF rather than run personally. She presented on preparing for endometriosis surgery in a webinar series hosted by UCSF's endometriosis center with ENACT, a UCSF and Stanford endometriosis research program. In a UCSF Health staff spotlight, she describes helping create patient resources, organizing community education events, and producing an interactive educational video about endometriosis with UCSF residents.
Her one endometriosis publication is a 2017 surgical video in the journal Fertility and Sterility, made during residency, showing how MRI findings before surgery compared with what was found during surgery for deep endometriosis. Her other publications are not focused on endometriosis.
Much of her public role is in surgical teaching. She has served as director of robotic surgery education and simulation for UCSF's OB/GYN department. Her awards include a 2024 award for best robotic surgery abstract or video at the AAGL Global Congress (AAGL is a major professional society for gynecologic surgeons) and a 2023 UCSF award for outstanding resident teaching. She has also described serving on an AAGL committee supporting early-career surgeons and on the board of SurgeryU, an AAGL video library for practicing surgeons.
Post-Surgical Care
Close Contact in the Days After Surgery
In the UCSF webinar, Dr. Ito said she sets expectations before surgery about recovery, including a plan for pain medication and clear guidance on what to contact the team about, and that she wants patients to know she is available to them after surgery. In two patient examples she shared, she saw the patients herself about three weeks after surgery. A 2026 Nancy's Nook account describes phone calls from Dr. Ito or her nurse practitioner on each of the first three days after surgery, and an eight-week follow-up visit at which the patient was cleared for normal activity.
No public statement from Dr. Ito on hormonal treatment after surgery was found. One 2026 Nancy's Nook account describes being prescribed a progestin hormone to manage symptoms while waiting for surgery, and one 2024 Reddit account describes being recommended Myfembree, a hormonal medication, after surgery.
Ask directly
- For how long do you continue to see patients after surgery?
- Do you recommend hormonal treatment or birth control after surgery, and what is your reasoning?
Philosophy and Fit
Realistic Expectations and Shared Decisions on Fertility and Bowel Disease
Dr. Ito's UCSF biography describes a focus on individualized care plans for patients who have been treated by many providers before reaching her. In the UCSF webinar, she said she tries early on to understand whether a patient has reasons to distrust the medical system, and wants patients to feel heard at UCSF. She described being realistic with patients about how much pain improvement to expect based on their history, imaging, and past surgeries, and said she never wants to push a patient into a treatment plan they do not agree with.
Fertility is part of her conversation before surgery even when imaging looks mild. She asks whether a patient wants a future pregnancy, including whether a patient who says no has given up on it because of pain, and discusses in advance how the patient would want the tubes and ovaries handled if disease is found on them. She described a similar conversation about the bowel, discussing beforehand how a patient would want bowel disease managed if found, and noting that surgeons debate whether bowel endometriosis always needs aggressive removal.
Ask directly
- What percentage of your surgical cases involve endometriosis?
- If adenomyosis is found during surgery, how do you handle that in a patient who wants to preserve fertility?
Sources
- UCSF Health - Dr. Traci E. Ito provider page
- UCSF Profiles - Traci Ito, MD
- UCSF Department of Obstetrics, Gynecology and Reproductive Sciences - Traci Ito, MD
- Women of UCSF Health - Traci E. Ito, MD, FACOG staff spotlight
- YouTube - UCSF endometriosis center and ENACT webinar on care before endometriosis surgery and pelvic floor health
- ENACT - UCSF-Stanford Endometriosis Center for Discovery, Innovation, Training and Community Engagement
- Magnetic resonance imaging correlation to intraoperative findings of deeply infiltrative endometriosis - Fertility and Sterility, 2017
- Healthgrades - Dr. Traci Ito
- Nancy's Nook - surgeon listing and patient accounts
- Reddit - patient accounts
- Facebook patient group - patient account