[Surgical treatment of endometriosis]

The treatment of first intention for endometriosis must be surgery. In cases of infertility the surgical treatment of choice is laparoscopic surgery, maybe in conjunction with the medical treatment and possibly followed-up by a second-look. When there is pelvic pain, the treatment relies on complete exeresis of the endometriotic lesions. In this context, laparoscopic surgery is as efficient as laparotomy for dealing with ovarian endometriomas, deep endometriosis infiltrating the uterosacral ligaments, the rectovaginal septum and the bladder. However, in the majority of cases bowel endometriosis is still an indication to operate by laparotomy.