{"paper_id":"156ed0a6-8a86-42ff-a0a4-20c9c5d8290b","body_text":"JOURNAL TOOLS |\n| Journal policies |\n| Publishing options |\n| eTOC |\n| To subscribe |\n| Submit an article |\n| Recommend to your librarian |\nARTICLE TOOLS |\n| Publication history |\n| Reprints |\n| Permissions |\n| Cite this article as |\n| Share |\nYOUR ACCOUNT\nYOUR ORDERS\nSHOPPING BASKET\nItems: 0\nTotal amount: € 0,00\nHOW TO ORDER\nYOUR SUBSCRIPTIONS\nYOUR ARTICLES\nYOUR EBOOKS\nCOUPON\nACCESSIBILITY\nREVIEW Open access\nMinerva Obstetrics and Gynecology 2026 June;78(3):261-74\nDOI: 10.23736/S2724-606X.25.05808-7\nCopyright © 2025 THE AUTHORS\nThis is an open access article distributed under the terms of the CC BY-NC 4.0 license which allows users to distribute, remix, adapt and build upon the manuscript, as long as this is not done for commercial purposes, the user gives appropriate credits to the original author(s) and the source (with a link to the formal publication through the relevant DOI), provides a link to the license and indicates if changes were made.\nlanguage: English\nNerve-sparing techniques in deeply infiltrating endometriosis: a narrative review\nLacey C. BRENNAN 1, 2 ✉, Sarah SHAMIYA 3, 4, 5, Jade DESILETS 3, 4, 5, Nucelio LEMOS 3, 4, 5, 6, 7\n1 Department of Obstetrics and Gynecology, Peter Lougheed Centre, Calgary, AB, Canada; 2 Department of Obstetrics and Gynecology, University of Calgary, Calgary, AB, Canada; 3 Department of Obstetrics and Gynecology, Mount Sinai Hospital, Toronto, ON, Canada; 4 Department of Obstetrics and Gynecology, Women’s College Hospital, Toronto, ON, Canada; 5 Department of Obstetrics and Gynecology, University of Toronto, Toronto, ON, Canada; 6 Department of Gynecology, Federal University of São Paulo, São Paulo, Brazil; 7 Institute for Care and Rehabilitation in Neuropelveology and Gynecology, São Paulo, Brazil\nNerve-sparing gynecologic surgery has evolved as a critical advancement in the management of deeply infiltrating endometriosis, aiming to reduce postoperative dysfunction while preserving surgical efficacy. Historically, procedures such as radical hysterectomy and excision of deeply infiltrating endometriosis carried high risks of urinary, bowel, and sexual dysfunction due to inadvertent injury to pelvic autonomic nerves. Recent developments in pelvic neuroanatomy, enhanced laparoscopic visualization, and operative technique have enabled surgeons to identify and preserve key neural structures during dissection. This review traces the evolution of nerve-sparing surgery, from early radical oncologic techniques to contemporary minimally invasive approaches guided by functional anatomy. We highlight contributions from key innovators and describe standardized terminology for pelvic nerves, fasciae, and retroperitoneal spaces, which aim to improve surgical reproducibility. Surgical techniques including the laparoscopic neuronavigation technique, the Negrar Method, and hypogastric nerve-based dissection are presented in detail, emphasizing both neuroanatomical precision and practical application. The use of anatomical landmarks in settings without advanced equipment is also discussed. Special attention is given to bowel surgery in endometriosis, balancing radicality with preservation of pelvic nerve function. Collectively, these strategies underscore a shift toward personalized, anatomy-guided surgery that prioritizes both disease control and long-term quality of life. As interest in nerve-sparing approaches continues to grow, education, multidisciplinary collaboration, and ongoing refinement of surgical methods will be essential to broadening access and improving patient outcomes for patients with deeply infiltrating endometriosis.\nKEY WORDS: Laparoscopy; Endometriosis; Gynecologic surgical procedures","source_license":"CC0","license_restricted":false}