A new approach to avoid ovarian failure as well function-impairing adhesion formation in endometrioma infertility surgery

• Published in: Archives of gynecology and obstetrics Vol. 301; no. 5; pp. 1113 - 1115
• Main Authors: Torres-de la Roche, Luz Angela, Devassy, Rajesh, de Wilde, Maya Sophie, Cezar, Cristina, Krentel, Harald, Korell, Matthias, De Wilde, Rudy Leon
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.05.2020; Springer Nature B.V
• Subjects: Cysts; Endocrinology; Endometriosis; Ethics; Gynecology; Human Genetics; Infertility; Laparoscopy; Medical equipment; Medicine; Medicine & Public Health; News and Views; Obstetrics/Perinatology/Midwifery; Production capacity; Surgery; Ovarian cyst surgery; Minimal invasive surgical procedures; Peritoneal adhesions; Modified polysaccharide agent
• ISSN: 0932-0067; 1432-0711
• DOI: 10.1007/s00404-020-05483-9

Purpose Deep ovarian endometriosis surgery is likely to be associated with diffuse bleeding, intraoperative ovarian tissue destruction and perioperative adhesion formation. A new surgical approach is hereby proposed to avoid the negative short-term impact of classic laparoscopic cystectomy on ovarian reserve. Results The need for intraoperative periovarian coagulation after endometrioma excision was avoided by combining the gold standard minimal-access endometrioma stripping technique with a purely plant-based medical product with high-hemostatic and antiadhesion barrier properties. Conclusion Endometrioma stripping followed by the application of a polysaccharide agent could avoid ovarian failure and at same time could reduce adhesion formation, thereby preserving tubo-ovarian function in endometrioma surgery. We encourage other surgically working groups to investigate middle- and long-term effects of this combined technique.