Conservative laparoscopic excision of endometriosis by sharp dissection: life table analysis of reoperation and persistent or recurrent disease

Redwine, David B.

doi:10.1016/s0015-0282(16)54591-9

Cited by 243 publications

(103 citation statements)

References 19 publications

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“…29 After laparoscopic endometriosis surgery, the odds of adhesion formation range from 80% to 100%. 30 The high incidence of adhesion formation after surgery for endometriosis underscores the importance of optimizing the surgical technique and the possible role of anti-adhesion drugs to potentially reduce adhesion formation. To reduce postoperative adhesion, we prefer to use adhesion barrier gels (Hyalobarrier Gel; The Nordic Group, Paris France).…”

Section: Fenestration and Ablation (Fulguration Or Vaporization)mentioning

confidence: 99%

A review article on ovarian cystectomy in endometriomas by laparoscopy

Yadav

Patel

2017

Int J Reprod Contracept Obstet Gynecol

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Endometrioma is one of the most frequent adnexal masses in the reproductive population. Medical therapy is inefficient and cannot be recommended in the management of ovarian endometriomas. The general consensus is that ovarian endometriomas larger than 4 cm should be removed, both to reduce pain and to improve spontaneous conception rates. The removal of ovarian endometriomas can be difficult, as the capsule is often densely adherent. While the surgical treatment of choice is surgical laparoscopy, for conservative treatment, the preferred method is modified combined cystectomy. Cystectomy can be destructive for the ovary, whereas ablation may be incomplete, with a greater risk of recurrence.

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Section: Fenestration and Ablation (Fulguration Or Vaporization)mentioning

confidence: 99%

A review article on ovarian cystectomy in endometriomas by laparoscopy

Yadav

Patel

2017

Int J Reprod Contracept Obstet Gynecol

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“…In case of bladder endometriosis, partial cystectomy is the surgical treatment of reference. This operation has been conducted by operative laparoscopy as described elsewhere [41,42]. Moreover, clinicians use laparoscopic surgical resection in cases of deep endometriosis infiltrating the uterosacral ligaments [43][44][45][46][47].…”

Section: Choosing the Best Surgical Approachmentioning

confidence: 99%

Quality of Life Improvement after Surgery for Deep Infiltrating Endometriosis (DIE)

Simedrea¹

2015

Surgery

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Journal of Surgery BackgroundEndometriosis is a painful and chronic gynecologic disorder, characterized by the presence of ectopic endometrium outside the endometrial cavity. Under this situation endometrial cells are implanted ectopically, that lead to retrograde menstruation via the fallopian tubes into the pelvis [1]. Endometriosis affects at least 6.3 million women and girls predominantly of reproductive age in the United States, 1 million in Canada, and millions more worldwide. It is associated with pelvic pain and infertility [2]. Peritoneal endometriosis, ovarian endometriosis and DIE are the three clinical presentations of endometriosis that have been described before [3]. Furthermore, several classifications of DIE have been proposed. In one classification, three different types of DIE are distinguished [4]: (I) A large lesion in the peritoneal cavity, infiltrating conically with the deeper parts becoming progressively smaller is designated as type-1; (II) In type-2, the bowel is being retracted over the lesion, and becomes deeply situated in the rectovaginal septum without infiltrating it; (III) Spherically shaped lesions, situated deep in the rectovaginal septum, and are often only visible as a small typical lesion at laparoscopy or often not visible at all. In the year 1995, Donnez and Nisolle have proposed only two types of DIE, first being caused by the invasion of a very active peritoneal lesion deep in the retroperitoneal space. In cases of lateral peritoneal invasion, utero-sacral ligaments can be involved as well as the anterior wall of the recto-sigmoid bowel junction resulting in a retraction, adhesions and secondary obliteration of the cul-desac. A second type is pseudo-DIE where the lesion originates from the rectovaginal septum tissue and consists essentially of smooth muscle with active glandular epithelium and scanty stroma [5].Today it is believed that endometriotic lesions can penetrate deep either into the retroperitoneal space or into the walls of the pelvic organs [6]. However, the mechanism is not clear and little is known about the impact of the different types of surgery in the treatment of DIE on complications, pain, patients' quality of life (QOL), recurrence rate and pregnancy rate or fertility. The aim of this review is therefore to evaluate the quality of life improvement after the different surgical modalities for management of DIE based on the above-mentioned parameters. Material and MethodIn this review we have searched The PUBMED (March 2005 to July 2015) for relevant articles. Heading terms "deep infiltrating endometriosis, quality of life" (n1=33) and "deep infiltrating endometriosis" (n2=402) were used. All pertinent articles were retrieved without any language restriction. To ensure the relevance of the publications, additional inclusion criteria were applied. We have included only those studies that contained a clear explanation of the surgical technique, an effectual evaluation of pain and an explicit description of post-operative QOL. To ensure a complete review o...

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“…Although studies of excisional surgery are uncontrolled the lower recurrence rates reported after 1-3 years than after ablation suggests that it is equal or better [12][13][14]. The The peritoneum tends to be more adherent on the posterior wall of the broad ligament close to the uterus.…”

Section: Peritoneal Excisionmentioning

confidence: 99%

Laparoscopic Surgical Techniques for Endometriosis and Adenomyosis

Wood

Maher

Woods

2000

Diagnostic and Therapeutic Endoscopy

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The details ofsurgical techniques for laparoscopic removal of endometriosis and adenomyosis are described briefly in textbooks and gynaecological journal articles. We have described a wide variety of techniques for the various procedures required in the treatment of endometriosis and adenomyosis, excluding hysterectomy. The principles are based upon those used in removal of primary cancer lesions. The limitations of thermal ablation are discussed, and evidence of improved results after excision of lesions have been submitted for publication.

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Conservative laparoscopic excision of endometriosis by sharp dissection: life table analysis of reoperation and persistent or recurrent disease

Cited by 243 publications

References 19 publications

A review article on ovarian cystectomy in endometriomas by laparoscopy

A review article on ovarian cystectomy in endometriomas by laparoscopy

Quality of Life Improvement after Surgery for Deep Infiltrating Endometriosis (DIE)

Laparoscopic Surgical Techniques for Endometriosis and Adenomyosis

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