The role of laparoscopy in the treatment of endometriosis

The aim of the present study was to evaluate the role of laparoscopy not only in the diagnosis but also in the therapy of pelvic endometriosis. Ninety-four patients underwent laparoscopy between May 1991 and May 1993. The patients were divided into 2 groups, according to the indication for laparoscopy: group I (benign ovarian cysts n = 47); group II (chronic pelvic pain, n = 47). All laparoscopies were performed by 2 surgeons only. When present, endometriosis was scored according to the American Fertility Society revised classification 1985 (AFS 1985). Endometriosis was present in 37 (39.4%) of the 94 patients included in the study: 19 out of 47 (40.4%) in group I, 18 out of 47 (38.3%) in group II. In 29 patients with endometriosis (78.3%), the score was reduced surgically during the diagnostic procedure. In 24 cases (82.8%) by laparoscopy and in 5 cases (17.2%) only, by laparotomy. Therefore, the careful selection of cases, the use of appropriate instruments and the experience in endoscopic surgery, combined with a good knowledge of pelvic anatomy, may allow the treatment of endometriosis immediately after diagnosis by laparoscopy, resulting in shorter hospitalization, less physical trauma, and a lower number of post-operative adhesions.