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Updated: Jun 18, 2026
Surgical Techniques to Optimize Ovarian Reserve during Laparoscopic Cystectomy for Ovarian Endometrioma
Published on: January 22, 2022
Laparoscopic conservative surgery for stage IV symptomatic endometriosis: short-term surgical complications
Luca Minelli1, Marcello Ceccaroni1, Giacomo Ruffo2
1Department of Obstetrics and Gynecology, Sacro Cuore Don Calabria General Hospital, Negrar, Verona, Italy; Gynecologic Oncology Division, Sacro Cuore Don Calabria General Hospital, Negrar, Verona, Italy.
Objective:
To study severe endometriosis as a cause of pelvic pain, which represents one of the most challenging disorders in gynecology.
Design:
Retrospective study.
Setting:
Teaching hospital.
Patient(S):
A total of 1,363 women with severe endometriosis (revised American Society for Reproductive Medicine [rASRM] stage IV).
Interventions:
A detailed survey of all patients with severe endometriosis (rASRM stage IV) who underwent laparoscopy at our center between January 2004 and December 2007 was carried out.
Main Outcome Measure(S):
Clinical and surgical data were retrieved and assessed according to the extent of surgery performed. Intraoperative, ultra-short, and short-term clinical complications were assessed.
Results:
A total of 1,201 women underwent laparoscopic radical surgery with excision of all visible endometriotic lesions, with a significant improvement of symptoms at 1-month follow-up evaluation. The overall intraoperative complication rate was 2.0%. The morbidity was significantly increased when bowel surgery was performed, with a risk of intraoperative complications that was threefold higher. Of the patients who had bowel surgery, 18 (4.1%) required reintervention within the first week after surgery.
Conclusion(S):
We report on the safety and efficacy of laparoscopic eradication of all visible implants in cases of rASRM stage IV endometriosis when surgery is performed in a referral center.
