This focused issue on “Endometriosis Surgery” is edited by Dr. Andrea Tinelli, from Department of Obstetrics and Gynecology, "Vito Fazzi" Hospital, Lecce, Italy.
Endometriosis is a very frequent and complex pathology, affecting many women around the world and the trend of diagnosis and treatment is constantly growing. The diagnosis often comes after a long and expensive journey, most of the times experienced with serious psychological repercussions for the woman. Women suffering from endometriosis report pain. Endometriosis is a cause of sub-fertility or infertility (30-40% of cases) and the impact of the disease is high and is related to the reduction in quality of life and to direct and indirect costs. After a very complex and varied diagnostic procedure, one often comes to having to decide on surgical treatment. Endometriosis surgery must aim at the complete elimination of all the outbreaks present, possibly preserving as much as possible the internal genital structures, i.e. the uterus, the salpinges or tubes, the ovaries and freeing the pelvis from the frequent adhesions that the disease causes to form between the organs of the female pelvis. These fibrotic adhesions and degenerations are the cause of the severe pain that the woman feels during the active phase of the disease. Surgical therapy must however tend to be conservative and sparing the pelvic innervation.
Endometriosis surgery should in fact be reserved for purely therapeutic purposes, primarily for the resolution-reduction of the associated pain symptoms and/or in case of conditions of functional impairment of organs or systems not responsive or not resolvable with medical treatment.
Endometriosis surgery can make use of many instrumental options, such as single and bipolar electricity instruments, diathermocoagulation, ultrasound instruments, various types of lasers and helium vaporizers.
This issue should propose a revision of the current surgical techniques and instruments used in endometriosis surgery, with innovative proposals for resolving/improving intervention.