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Surgical Techniques to Optimize Ovarian Reserve during Laparoscopic Cystectomy for Ovarian Endometrioma
Published on: January 22, 2022
[Surgical treatments for endometriosis]
Afchine Fazel1, Justine Boitard1
1Service de gynécologie-obstétrique, Hôpital Lariboisière, 2 rue Ambroise-Paré, 75010 Paris, France.
Abstract:
Complete resection of scattered superficial lesions can be paradoxically more complex. If the endometriosis is ovarian, priority should be given to preserving the oocyte capital, and ovarian function should be assessed in patients of childbearing age who wish to become pregnant, prior to treatment by alcoholization of the cyst, abrasion of its contents by laser or plasma energy, or even cystectomy. Laparoscopic resection is recommended in cases of deep endometriosis. After a thorough clinical examination and precise imaging, deep lesions are treated by resection and shaving in the case of digestive or ureteral localizations, or even by discoid resection or digestive anastomosis resection with or without stoma, depending on fistula risk criteria. The aim is to reduce pain and functional consequences, while preserving ovarian function to improve pregnancy rates.
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