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Techniques for Ablation and Excision of Endometriosis

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Abstract

The goals of surgical treatment of endometriosis are to completely ablate and/or excise active endometriotic tissue and correct anatomic distortions caused by adhesions and cystic lesions.1 Over the past few years, laparoscopic surgery has become a valuable addition to conventional and microsurgical approaches by laparotomy. The choice of approach (laparotomy or laparoscopy), surgical technique (excision, coagulation, vaporization), and instruments (CO2 laser, electrocautery, or scissors) is according to the surgeon’s preference (see Figs. 10.1 through 10.6 and color plates 10.1 through 10.6). The key issue is to adequately identify and treat the disease. By selecting the most effective surgical modality for each location and each patient, the desired postoperative results can best be achieved. A wide variety of surgical and medical treatments are now available, but it is important to take into account the limits of each approach.

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References

  1. Cook AS, Rock JA. The role of laparoscopy in the treatment of endometriosis. Fertil Steril 1991;55:663–680.

    PubMed  CAS  Google Scholar 

  2. Bruhat MA, Mage G, Pouly JL, et al. Operative laparoscopy. New York: McGraw Hill Inc., 1992.

    Google Scholar 

  3. Canis M, Mage G, Manhes H, et al. Laparoscopic treatment of endometriosis. Acta Obstet Gynecol Scand 1989; (Suppl. 150):15–20.

    CAS  Google Scholar 

  4. Janssen RPS, Russel P. Nonpigmented endometriosis: clinical, laparoscopic and pathologic definition. Am J Obstet Gynecol 1986;155:1154–1159.

    Google Scholar 

  5. Martin DC, Hubert GD, Vander Zwaag R, et al. Laparoscopic appearances of peritoneal endometriosis. Fertil Steril 1989;51:63–67.

    PubMed  CAS  Google Scholar 

  6. Koninckx PR, Meuleman C, Demeyere S, et al. Suggestive evidence that pelvic endometriosis is a progressive disease, whereas deeply infiltrating endometriosis is associated with pelvic pain. Fertil Steril 1991;55:759–765.

    PubMed  CAS  Google Scholar 

  7. Candiani GB, Vercellini P, Fedele L. Laparoscopic ovarian puncture for correct staging of endometriosis. Fertil Steril 1990;53:994–997.

    PubMed  CAS  Google Scholar 

  8. Reich H, McGlynn F, Salvat J. Laparoscopic treatment of cul-de-sac obliteration secondary to retrocervical deep fibrotic endometriosis. J Reprod Med 1991;36:516–522.

    PubMed  CAS  Google Scholar 

  9. Martin DC, Berry JD. Histology of chocolate cysts. J Gynecol Surg 1990;6:43–46.

    Article  Google Scholar 

  10. Martin DC. Laparoscopic and vaginal colpotomy for the excision of infiltrating cul-de-sac endometriosis. J Reprod Med 1988;33:806–808.

    PubMed  CAS  Google Scholar 

  11. Mage G, Canis M, Manhes H, et al. Laparoscopic management of adnexal cystic masses. J Gynecol Surg 1990;6:7–19.

    Article  Google Scholar 

  12. Heaps JM, Nieberg RK, Berek JS. Malignant neoplasms arising in endometriosis. Obstet Gynecol 1990;75: 1023–1028.

    PubMed  CAS  Google Scholar 

  13. Pittaway DE, Daniell JF, Maxson WL. Ovarian surgery in an infertility patient as an indication for a short-interval second-look laparoscopy: a preliminary study. Fertil Steril 1985;44:611–614.

    PubMed  CAS  Google Scholar 

  14. Hughesdon PE. The structure of endometrial cysts of the ovary. J Obstet Gynaecol British Empire 1957;44: 481–487.

    Article  Google Scholar 

  15. Canis M, Bassil S, Wattiez A, et al. Fertility following laparoscopic management of benign adnexal cysts. Hum Reprod 1992;7:529–531.

    PubMed  CAS  Google Scholar 

  16. Canis M, Mage G, Wattiez A, et al. Second-look laparoscopy after laparoscopic cystectomy of large ovarian endometriomas. Fertil Steril 1992;58:617–619.

    PubMed  CAS  Google Scholar 

  17. Nezhat C, Crowgey S, Nezhat F. Videolaseroscopy for the treatment of endometriosis associated with infertility. Fertil Steril 1989;51:237–240.

    PubMed  CAS  Google Scholar 

  18. Fayez JA, Vogel MF. Comparison of different treatment methods of endometriomas by laparoscopy. Obstet Gynecol 1991;78:660–665.

    PubMed  CAS  Google Scholar 

  19. Donnez J, Nisolle M, Karaman Y, et al. CO2 laser laparoscopy in peritoneal endometriosis and in ovarian endometrial cyst. J Gynecol Surg 1989;5:361–366.

    Article  Google Scholar 

  20. Martin DC. Laparoscopic treatment of ovarian endometriomas. Clinical Obstet Gynecol 1991;34:452–459.

    Article  CAS  Google Scholar 

  21. Operative Laparoscopy Study Group. Postoperative adhesion development after operative laparoscopy: evaluation at early second-look procedures. Fertil Steril 1991;55:700–704.

    Google Scholar 

  22. Luciano AA, Maier B, Koch EL, et al. A comparative study of postoperative adhesions following laser surgery by laparoscopy versus laparotomy in the rabbit model. Obstet Gynecol 1990;74:220–224.

    Google Scholar 

  23. Nezhat CR, Nezhat FR, Metzger DA, et al. Adhesion reformation after reproductive surgery by videolaseroscopy. Fertil Steril 1990;53:1008–1011.

    PubMed  CAS  Google Scholar 

  24. Perez JJ. Laparoscopic presacral neurectomy: results of the first 25 cases. J Reprod Med 1990;35:625–630.

    PubMed  CAS  Google Scholar 

  25. Lichten EM, Bombard J. Surgical treatment of primary dysmenorrhea with laparoscopic uterine nerve ablation. J Reprod Med 1987;32:37–41.

    PubMed  CAS  Google Scholar 

  26. Tjaden B, Schlaff WD, Kimball A, et al. The efficacy of presacral neurectomy for the relief of midline dysmenorrhea. Obstet Gynecol 1990;76:89–91.

    PubMed  CAS  Google Scholar 

  27. Grainger DA, Soderstrom RM, Schiff SF, et al. Ureteral injuries at laparoscopy: Insights into Diagnosis, Management and Prevention. Obstet Gynecol 1990;75:839–843.

    PubMed  CAS  Google Scholar 

  28. Nezhat C, Nezhat F. A simplified method of laparoscopic presacral neurectomy for the treatment of central pelvic pain due to endometriosis. Br J Obstet Gynaecol 1992;99: 659–663.

    Article  PubMed  CAS  Google Scholar 

  29. Canis M, Mage G, Chapron C, et al. Laparoscopic hysterectomy: A preliminary study. Surg Endosc 1993;7:42–45.

    Article  PubMed  CAS  Google Scholar 

  30. Montgomery JC, Studd JWW. Oestradiol and testosterone implants after hysterectomy for endometriosis. In Bruhat MA, Canis M, eds. Endometriosis. Karger Basel 1987, Contr Gynec Obstet 16, pp 241–246.

    Google Scholar 

  31. Chassagnard F. External endometriosis. Results of laparoscopic treatment of endometriosis in pain and in infertile patients. Indication and results for IVF in endometriosis. These Medicale Clermont Ferrand 1990.

    Google Scholar 

  32. Vancaillie T, Schenken RS. Laparoscopic treatment. In Schenken RS, ed. Endometriosis: contemporary concepts in clinical management. Philadelphia, JB Lippincott 1989, 251–266.

    Google Scholar 

  33. Mettler L, Semm K. Three step medical and surgical treatment of endometriosis. Ir J Med Sci 1983;152: 26–28.

    Article  PubMed  Google Scholar 

  34. Canis M, Pouly JL, Wattiez A, et al. Incidence of bilateral adnexal disease in severe endometriosis (Revised-American Fertility Society, Stage IV). Should a stage V be included in the American Fertility Society Classification? Fertil Steril 1992;57:691–692.

    PubMed  CAS  Google Scholar 

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© 1995 Springer-Verlag New York, Inc.

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Canis, M., Bruhat, M.A., Pouly, J.L., Cooper, M.J.W., Wattiez, A., Manhes, H. (1995). Techniques for Ablation and Excision of Endometriosis. In: Nezhat, C.R., Berger, G.S., Nezhat, F.R., Buttram, V.C., Nezhat, C.H. (eds) Endometriosis. Springer, New York, NY. https://doi.org/10.1007/978-1-4613-8404-5_10

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  • DOI: https://doi.org/10.1007/978-1-4613-8404-5_10

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4613-8406-9

  • Online ISBN: 978-1-4613-8404-5

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