Chirurgia Annessiale “fertility sparing” nell’endometriosi profonda

Chirurgia Annessiale “fertility sparing” nell’endometriosi profonda

Anna Katarzyna StepniewskaOrcid, Giulia Mantovani1, Chiara Signori1, Maria Manzone1, Silvia BaggioOrcid, Paola De MitriOrcid, Marcello CeccaroniOrcid

1 – Dipartimento per la Tutela della Salute e della Qualità di Vita della Donna, ISSA International School of Surgical Anatomy, IRCCS Ospedale Sacro Cuore Don Calabria, Negrar, Verona

Autore di riferimento: Anna Katarzyna Stepniewska

stepniewska.anna@gmail.com


DOI: 10.53146/lriog1202132

Abstract

Adnexal surgery in deep endometriosis represents a significant clinical problem because the patients who suffer from it are typically of childbearing age and often, in addition to aiming for the improvement of painful sym- ptoms, have a desire for pregnancy. Endometriosis can cause infertility and the surgical removal of the disease implies a good chance of conception; at the same time surgery, in particular of endometriomas, involves the risk of a reduction in the ovarian reserve, up to its extreme consequence represented by premature menopause. For this reason, the indications for surgery must be evaluated very carefully and accompanied by an appropriate instrumental study that allows for an adequate surgical procedure; all this, in order to radically remove the disease and not expose the patient to a high risk of recurrence resulting in subsequent surgical gestures and a consequent further reduction of the ovarian reserve. Histological, anatomical aspects and hints on surgical instrumentation are presented, all useful for choosing the most appropriate surgical approach. The various traditional and innovative surgical techniques are also discussed and other additional procedures useful to reduce the risk of decreased ovarian reserve and postoperative adhesions are described.

Keywords: deep endometriosis; laparoscopic surgery; ovarian reserve; fertility.


Presente in LRIOG Nr.3 – 2021

e-ISSN: 1824-0283


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