Laparoscopic Excision of Endometriosis

  • Rebecca Rossener
  • Luiz Fernando Pina Carvalho
  • Juan Luis Salgado
  • Mauricio S. Abrao


Endometriosis is a gynecologic disease that affects more than 150 million women around the world. The disease is usually found in the pelvic cavity, affecting the ovaries, the fallopian tubes, the peritoneum, and the rectovaginal septum; it is less commonly found in the abdominal cavity affecting the small bowel, the large bowel, and other abdominal organs. It has been established that the best examination to evaluate endometriosis is transvaginal ultrasonography with bowel preparation. The laparoscopic ablation or excision of endometriotic lesions has as its objectives pain relief or fertility improvement and increasing the patient’s quality of life. It is essential to remove all visible lesions and to biopsy the doubtful ones in order to reduce the chances of recurrences and repeat surgery.


Laparoscopic Surgery Bowel Preparation Transvaginal Ultrasonography Pelvic Cavity Uterosacral Ligament 
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  1. 1.
    Burney RO, Giudice LC. Pathogenesis and pathophysiology of endometriosis. Fertil Steril. 2012;98:511–9.PubMedCrossRefGoogle Scholar
  2. 2.
    Giudice LC. Clinical practice. Endometriosis. N Engl J Med. 2010;362:2389–98.PubMedCentralPubMedCrossRefGoogle Scholar
  3. 3.
    Huang H, Li C, Zarogoulidis P, Darwiche K, Machairiotis N, Yang L, et al. Endometriosis of the lung: report of a case and literature review. Eur J Med Res. 2013;18:3.CrossRefGoogle Scholar
  4. 4.
    Arruda MS, Petta CA, Abrão MS, Benetti-Pinto CL. Time elapsed from onset of symptoms to diagnosis of endometriosis in a cohort study of Brazilian women. Hum Reprod. 2003;18:756–9.PubMedCrossRefGoogle Scholar
  5. 5.
    Nnoaham KE, Hummelshoj L, Webster P, d’Hooghe T, de Cicco Nardone F, et al. World Endometriosis Research Foundation Global Study of Women’s Health Consortium. Impact of endometriosis on quality of life and work productivity: a multicenter study across ten countries. Fertil Steril. 2011;96:366–73.Google Scholar
  6. 6.
    Revised American Society for Reproductive Medicine classification of endometriosis: 1996. Fertil Steril. 1997;67:817–21.Google Scholar
  7. 7.
    Chapron C, ABrao MS, Miller CE. Endometriosis classification need to be revied: A new one is arriving. NewsScope.2012; 26:9.Google Scholar
  8. 8.
    Bellelis P, Dias Jr JA, Podgaec S, Gonzales M, Baracat EC, Abrão MS. Epidemiological and clinical aspects of pelvic endometriosis – a case series [in English and Portuguese]. Rev Assoc Med Bras. 2010;56:467–71.PubMedCrossRefGoogle Scholar
  9. 9.
    Sampson JA. Metastatic or embolic endometriosis, due to the menstrual dissemination of endometrial tissue into the venous circulation. Am J Pathol. 1927;3:93–110.PubMedCentralPubMedGoogle Scholar
  10. 10.
    Carvalho L, Podgaec S, Bellodi-Privato M, Falcone T, Abrão MS. Role of eutopic endometrium in pelvic endometriosis. J Minim Invasive Gynecol. 2011;18:419–27.PubMedCrossRefGoogle Scholar
  11. 11.
    Nouri K, Ott J, Krupitz B, Huber JC, Wenzl R. Family incidence of endometriosis in first-, second-, and third-degree relatives: case–control study. Reprod Biol Endocrinol. 2010;8:85.PubMedCentralPubMedCrossRefGoogle Scholar
  12. 12.
    Abrão MS, Podgaec S, Pinotti JA, de Oliveira RM. Tumor markers in endometriosis. Int J Gynaecol Obstet. 1999;66:19–22.PubMedCrossRefGoogle Scholar
  13. 13.
    Patrelli TS, Berretta R, Gizzo S, Pezzuto A, Franchi L, Lukanovic A, et al. CA 125 serum values in surgically treated endometriosis patients and its relationships with anatomic sites of endometriosis and pregnancy rate. Fertil Steril. 2011;95:393–6.PubMedCrossRefGoogle Scholar
  14. 14.
    Abrao MS, Gonçalves MO, Dias Jr JA, Podgaec S, Chamie LP, Blasbalg R. Comparison between clinical examination, transvaginal sonography and magnetic resonance imaging for the diagnosis of deep endometriosis. Hum Reprod. 2007;22:3092–7.PubMedCrossRefGoogle Scholar
  15. 15.
    Dell’oro M, Collinet P, Robin G, Rubod C. Multidisciplinary approach for deep endometriosis: interests and organization [article in French]. Gynecol Obstet Fertil. 2013;41:5864.Google Scholar
  16. 16.
    Triolo O, Laganà AS, Sturlese E. Chronic pelvic pain in endometriosis: an overview. J Clin Med Res. 2013;5:153–63.PubMedCentralPubMedGoogle Scholar
  17. 17.
    Chapron C, Dubuisson JB, Fernandez B, Dousset B. Surgical treatment of endometriosis [article in French]. Rev Prat. 1999;49:276–8.PubMedGoogle Scholar
  18. 18.
    Bianchi PH, Pereira RM, Zanatta A, Alegretti JR, Motta EL, Serafini PC. Extensive excision of deep infiltrative endometriosis before in vitro fertilization significantly improves pregnancy rates. J Minim Invasive Gynecol. 2009;16:174–80. Erratum in J Minim Invasive Gynecol. 2009;16:663.PubMedCrossRefGoogle Scholar
  19. 19.
    Paka C, Miller J, Nezhat C. Predictive factors and treatment of recurrence of endometriosis. Minerva Ginecol. 2013;65:105–11.PubMedGoogle Scholar
  20. 20.
    Chapron C, Fritel X, Dubuisson JB. Fertility after laparoscopic management of deep endometriosis infiltrating the uterosacral ligaments. Hum Reprod. 1999;14:329–32.PubMedCrossRefGoogle Scholar
  21. 21.
    Practice Committee of American Society for Reproductive Medicine. Treatment of pelvic pain associated with endometriosis. Fertil Steril. 2008;90(5 Suppl):S260–9.Google Scholar
  22. 22.
    Khan J, Gill M, Clarke H. Onset of benign paroxysmal positional vertigo after total laparoscopic hysterectomy in the Trendelenburg position. J Minim Invasive Gynecol. 2012;19:798–800.PubMedCrossRefGoogle Scholar
  23. 23.
    Vargas-Hernández VM. Endometriosis as a risk factor for ovarian cancer [in Spanish]. Cir Cir. 2013;81:163–8.PubMedGoogle Scholar
  24. 24.
    Donnez J, Squifflet J, Jadoul P, Lousse JC, Dolmans MM, Donnez O. Fertility preservation in women with ovarian endometriosis. Front Biosci (Elite Ed). 2012;4:1654–62.CrossRefGoogle Scholar
  25. 25.
    Somigliana E, Benaglia L, Vigano P, Candiani M, Vercellini P, Fedele L. Surgical measures for endometriosis-related infertility: a plea for research. Placenta. 2011;32 Suppl 3:S238–42.PubMedCrossRefGoogle Scholar
  26. 26.
    Sugita A, Iwase A, Goto M, Nakahara T, Nakamura T, Kondo M, et al. One-year follow-up of serum antimüllerian hormone levels in patients with cystectomy: are different sequential changes due to different mechanisms causing damage to the ovarian reserve? Fertil Steril. 2013;100(2):516–22.e3.PubMedCrossRefGoogle Scholar
  27. 27.
    Koninckx PR, Ussia A, Adamyan L, Wattiez A, Donnez J. Deep endometriosis: definition, diagnosis, and treatment. Fertil Steril. 2012;98:564–71.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Rebecca Rossener
    • 1
  • Luiz Fernando Pina Carvalho
    • 1
  • Juan Luis Salgado
    • 2
  • Mauricio S. Abrao
    • 1
  1. 1.Department of Obstetrics and GynecologyUniversity of São PauloSão PauloBrazil
  2. 2.Department of Obstetrics and GynecologyUniversidad Central Caribe School of MedicineBayamonUSA

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