Sandy soil drains fast, so established trees in Imperial Beach send roots wherever they can find water. The older sewer lines near the pier, with their decades of joints and seams, leak just enough moisture to draw them in. A root gets in through an opening thinner than a pencil line and keeps growing, from a thin root to a mass to a blockage that backs up the house.
If it's happened more than once, this is why. Clearing removes the roots but leaves their way in open, and roots grow back through the same opening. That keeps happening until the opening itself gets closed. The camera helps find it, showing the joint or crack, how established the intrusion is, and whether it's one entry or several. That picture is what separates another temporary clearing from a longer term fix.
The plan comes from that picture, sealing the entry, or repairing the section if the section has failed. All of it is explained in plain English, decided by you at your pace, and performed by or under a licensed contractor when you say go.