Surgical treatment of endometriosis in infertility
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Selective removal of the endometriosis must be associated with careful restoration of the pelvic organs and a normal tubo-ovarian relationship. Meticulous attention should be paid to the repair of the ovarian and tubal surfaces and the pelvic peritoneum to avoid postoperative adhesions. Such adhesions will interfere with the tuboovarian function, produce pseudocyst formation and encapsulation of the ovary.
The use of fine dissection techniques and the continuous protection of the pelvic peritoneum with warm irrigation fluid, glass hooks and silastic sheets are some aspects of the method used. However, the most important factor avoiding iatrogenic trauma is “gentle tissue handling” which often meansachange of attitude on the part of the surgeon.
Although reconstructive surgery of endometriosis is unlikely to be a cure of all infertility factors associated with endometriosis it can restore fertility in patients with severe and extensive degrees almost to the same extent as in patients with mild and moderate degrees of endometriosis.
KeywordsInfertility Endometriosis Pelvic Organ Peritoneal Fluid Ovarian Surface
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