LAPAROSCOPIC REMOVAL OF ENDOMETRIOMAS: SONOGRAPHIC EVALUATION OF RESIDUAL FUNCTIONING OVARIAN TISSUE

Objective. The use of the laparoscopic approach, in particular the "stripping" technique, has been questioned because it could involve excessive removal of ovarian tissue with loss of follicles. The aim of this study was to determine how and if the laparoscopic removal of ovarian endometriotic cysts is a tissue-sparing procedure. Setting. University Hospital. Patients. Fifty-two patients in fertile age with an ovarian endometrioma, correctly diagnosed by sonography, undergoing laparoscopic removal by stripping. Interventions. Laparoscopic removal of ovarian endometriomas by stripping and transvaginal sonographic (TVS) evaluation of residual ovarian tissue. Measurements and Main Results. Within one week before surgery all recruited patients underwent TVS evaluation of ovarian volume, size and morphology of the endometriotic cyst and measurement of the surrounding ovarian cortex. Within 6-12 months after laparoscopic excision, TVS measurements of residual ovarian tissues were obtained. Mean cyst diameter was 4.7+2.2 cm (range 2.1-9.2 cm). Ovarian residual cortex surrounding the cyst was ultrasonographically lower than the previous evaluation. Conclusion. Although laparoscopic approach is still the less invasive technique in treating ovarian endometriosis, it appears aggressive in terms of injuring the residual ovarian tissue.