Endoscopic treatment for endometriosis

Surgical therapy for the treatment of patients with symptomatic endometrios is has always been a mainstay of therapy; over the past decade, endoscopy h as largely replaced laparotomy. With the availability of improved laparosco pic instrumentation, most women can have the diagnostic and therapeutic int ervention performed at one setting. This article reviews surgical approache s to peritoneal disease, both superficial and deeply infiltrating, as well as ovarian, urinary, and gastrointestinal endometriotic disease. Surgical a pproaches to pelvic pain relief, such as presacral neurectomy and uterosacr al nerve resection are also discussed. Because no definitive cure is availa ble for endometriosis except castration, the formation of a rational treatm ent plan should lead to the most efficient number of repetitive surgical in terventions over the patient's reproductive lifetime.