• There are no suggestions because the search field is empty.
« Back to Articles

4 Types of Endometrioma Surgery and How They Differ

My Post (9)-1

An endometrioma is a blood-filled "chocolate" cyst that can occur when endometriosis tissue develops in the ovary. In many but not all cases, endometriomas are treated with surgery.

When considering endometrioma surgery, it is helpful to know what the various types of surgery are and how they differ.

Surgical treatment of endometrioma is done in one of the following ways:

    • Ovarian Cystectomy – The cyst is initially drained. The cyst wall is identified and the plane of cleavage between the cyst wall and normal ovarian tissue is identified. The inner lining of the cyst is then stripped from the normal ovarian tissue

    • Ablative Surgery – The cyst wall is opened, drained and washed out with irrigation fluid. The cyst wall is then destroyed using CO2 laser or bipolar coagulation

    • Two-Step Procedure – This is usually done for large cysts. At first-look laparoscopy, the cyst is opened, drained and washed. The patient is then treated with a GnRH agonist (Depo Lupron) for 3 months to decrease cyst size. A second-look laparoscopy is then performed. This time, the cyst is opened and the interior wall is vaporized with CO2 laser.

    • Combined Technique – This combines excision and ablation. The cyst wall is opened and washed out with irrigation fluid. The cyst wall is then stripped off (80 -90%) till the deep and vascular portion of the ovary (hilus) is reached. CO2 laser is used to vaporize the rest of the cyst wall.

Which technique is best?

  • Drainage alone does not work as the cyst will recur in a few weeks.

  • Excisional surgery results in a more favorable outcome in patients with pain. However, this technique results in more loss of antral follicles, ovarian volume and decreased ovarian response to stimulation.

  • Ablation with CO2 laser or plasma energy technology results in less loss of normal ovarian tissue than bipolar coagulation.

Considerable surgical expertise is required to decrease ovarian damage and avoid incomplete surgery.

To see a fertility specialist with experience treating endometrioma and the full range of fertility issues, make an appointment at one of InVia's four Chicago area fertility clinics.

trouble getting pregnant ebook

Infertility Infertility treatment Endometriosis

Dr. Vishvanath Karande

Dr. Vishvanath Karande

Dr. Karande is Board Certified in the specialty of Obstetrics and Gynecology as well as the subspecialty of Reproductive Endocrinology and Infertility. He is a Fellow of the American College of Obstetricians and Gynecologists and Member of the American Society for Reproductive Medicine.

Comments

Scheduleafafasdfasf

Schedule Now