Surgical Treatment of Deep Endometriosis

Endometriosis is a complex gynecological disease, which presents a challenge for researchers and surgeons alike. Ectopic deposits of endometrial tissue typically found in the pelvis contribute to disease progression. Associated symptoms of pain and infertility are often attributed to adhesion formation and anatomical distortion frequently responsible for the clinical consequences of the disease [1]. Endometrial tissue within the uterine cavity is responsible for preparing the embryo implantation and nourishing the developing fetus. In the absence of a pregnancy, the corpus luteum degenerates, and hormone levels drop, the effect of which results in shedding of the endometrial lining. This continuous cycle exposes women to constant fluctuations in hormones levels, which in turn regulates the endometrium. Endometriosis most commonly affects the ovaries, posterior cul-de-sac, and uterosacral ligaments [2]. Less frequently affected sites including the diaphragm, lungs, and even endometriotic implants involving the brain have been described [3].