Laparoscopy for Diagnosis and Treatment of Endometriosis

The aim of surgical management is to remove visible areas of endometriosis and restore anatomy by division of adhesions.Yet, treatment frequently must be individualized.However, distinguishing patients who need no treatment from patients who need intermediate or extensive treatment can be difficult.There are three recognized types of endometriosis: peritoneal endometriosis, ovarian endometriomas and deep adenomyotic nodules of the rectovaginal septum (Nisolle and Donnez, 1997).Few principles have to be considered regarding the surgical management of endometriosis:  Severe disease must be treated differently from mild to moderate disease. Patients with pain symptoms associated with endometriosis must be approached differently from patients seeking fertility. Clinicians and patients should be aware that the expected benefit is depending on operator skills (Vercellini et al., 2009).Jansen and Russell have shown that peritoneum which looks completely normal does not contain histological features of endometriosis, therefore excision of all abnormally looking peritoneum , deep nodules and ovarian lesions should remove the disease ( 1986).Yet a downside of this approach is the risk for future adhesion formation.www.intechopen.com