{"paper_id":"44f04d72-f3eb-4b71-9061-17a9e500e2fe","body_text":"Abstract\nEndometriosis surgery is performed laparoscopically. It’s a complex surgery requiring surgical experience and the regular practice of complex cases at a referral center. Unlike a pelvic MRI, which can be reinterpreted, surgery is a closed-door process between the surgeon and their assistant, and it might involve the anesthesiologist. The operative report is therefore a fundamental control document.\nFirst and foremost, the operative report must inform the patient and any other healthcare professionals of who may be involved in the patient’s care. The patient expects an extensive description of the lesions and of the surgical procedures. The surgeon must therefore aim to make this document intelligible.\nThe other issue concerns the standardization of data collection in the interests of research. Laparoscopy is the gold standard for the phenotypic evaluation of the disease, and lesion descriptions must be standardized and reproducible. The use of a single lexicon, following a consensual plan, and combining those with the use of classifications, scores, or staging validated by the scientific community should improve our knowledge of the disease while improving the flow of information.\nConsensus among endometriosis societies has been reached on the lexicon to be used to designate anatomical structures, how the peritoneal cavity should be explored, and the vocabulary to be used by the surgeon. The aim of this chapter is to summarize these data in a standardized operative report.\nAccess this chapter\nTax calculation will be finalised at checkout\nPurchases are for personal use only\nSimilar content being viewed by others\nReferences\nKarl Freiherr von Rokitansky (1804–1878). Embryo Project Encyclopedia [Internet]. https://embryo.asu.edu/pages/karl-freiherr-von-rokitansky-1804-1878. Accessed 24 Jul 2024.\nGiudice LC. Endometriosis. N Engl J Med. 2010;362(25):2389–98.\nVercellini P, Fedele L, Aimi G, Pietropaolo G, Consonni D, Crosignani PG. Association between endometriosis stage, lesion type, patient characteristics and severity of pelvic pain symptoms: a multivariate analysis of over 1000 patients. Hum Reprod. 2007;22(1):266–71.\nNetter A, d’Avout-Fourdinier P, Agostini A, Chanavaz-Lacheray I, Lampika M, Farella M, et al. Progression of deep infiltrating rectosigmoid endometriotic nodules. Hum Reprod. 2019;34(11):2144–52.\nBecker CM, Bokor A, Heikinheimo O, Horne A, Jansen F, Kiesel L, et al. ESHRE guideline: endometriosis†. Hum Reprod Open. 2022;2022(2):hoac009.\nTomassetti C, Johnson NP, Petrozza J, Abrao MS, Einarsson JI, Horne AW, et al. An international terminology for endometriosis, 2021. J Minim Invasive Gynecol. 2021;28(11):1849–59.\nVanhie A, Meuleman C, Tomassetti C, Timmerman D, D’Hoore A, Wolthuis A, et al. Consensus on recording deep endometriosis surgery: the CORDES statement. Hum Reprod. 2016;31:1219.\nBecker CM, Laufer MR, Stratton P, Hummelshoj L, Missmer SA, Zondervan KT, et al. World endometriosis research foundation endometriosis phenome and biobanking harmonisation project: I. Surgical phenotype data collection in endometriosis research. Fertil Steril. 2014;102(5):1213–22.\nBoutron I, Moher D, Altman DG, Schulz KF, Ravaud P, for the CONSORT Group. Extending the CONSORT statement to randomized trials of nonpharmacologic treatment: explanation and elaboration. Ann Intern Med. 2008;148(4):295.\nRashid R, Sohrabi C, Kerwan A, Franchi T, Mathew G, Nicola M, et al. The STROCSS 2024 guideline: strengthening the reporting of cohort, cross-sectional, and case-control studies in surgery. Int J Surg. 2024;110(6):3151–65.\nAgha RA, Sohrabi C, Mathew G, Franchi T, Kerwan A, O’Neill N, et al. The PROCESS 2020 guideline: updating consensus preferred reporting of CasESeries in surgery (PROCESS) guidelines. Int J Surg. 2020;84:231–5.\nSohrabi C, Mathew G, Maria N, Kerwan A, Franchi T, Agha RA, et al. The SCARE 2023 guideline: updating consensus surgical CAse REport (SCARE) guidelines. Int J Surg. 2023;109(5):1136–40.\nCrestani A, Merlot B, Goualard PH, Grigoriadis G, Chanavaz Lacheray I, Dennis T, et al. Bowel endometriosis: surgical customization is demanding. Best Pract Res Clin Obstet Gynaecol. 2024;94:102495.\nGillis C, Buhler K, Bresee L, Carli F, Gramlich L, Culos-Reed N, et al. Effects of nutritional Prehabilitation, with and without exercise, on outcomes of patients who undergo colorectal surgery: a systematic review and meta-analysis. Gastroenterology. 2018;155(2):391–410.e4.\nWillis MA, Toews I, Soltau SL, Kalff JC, Meerpohl JJ, Vilz TO. Preoperative combined mechanical and oral antibiotic bowel preparation for preventing complications in elective colorectal surgery. Cochrane Database Syst Rev. 2023;2(2):CD014909. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD014909.pub2/full. Accessed 2 Jan 2024.\nSaccardi C, Gizzo S, Vitagliano A, Noventa M, Micaglio M, Parotto M, et al. Peri-incisional and intraperitoneal ropivacaine administration: a new effective tool in pain control after laparoscopic surgery in gynecology: a randomized controlled clinical trial. Surg Endosc. 2016;30(12):5310–8.\nDaghmouri MA, Chaouch MA, Deniau B, Benayoun L, Krimi B, Gouader A, et al. Efficacy and safety of intraperitoneal ropivacaine in pain management following laparoscopic digestive surgery: a systematic review and meta-analysis of RCTs. Medicine (Baltimore). 2024;103(29):e38856.\nRoman H, Dennis T, Grigoriadis G, Merlot B. Robotic management of diaphragmatic endometriosis in 10 steps. J Minim Invasive Gynecol. 2022;29(6):707–8.\nBourdel N, Fava V, Budianu MA, Chauvet P, Canis M, Chadeyras JB. Laparoscopic resection of diaphragmatic endometriosis in 10 steps. J Minim Invasive Gynecol. 2019;26(7):1224–5.\nMoawad G, Youssef Y, Ayoubi JM, Feki A, De Ziegler D, Roman H. Diaphragmatic endometriosis: robotic approaches and techniques. Fertil Steril. 2022;118(6):1194–5.\nAhmad G, Baker J, Finnerty J, Phillips K, Watson A. Laparoscopic entry techniques. Cochrane Database Syst Rev. 2019;1(1):CD006583.\nTakeda S. Anatomical terminology/Terminologia Anatomica: a melting pot for creating a universal language of anatomy. Anat Sci Int. 2024;99:331.\nRoman H, Bubenheim M, Huet E, Bridoux V, Zacharopoulou C, Daraï E, et al. Conservative surgery versus colorectal resection in deep endometriosis infiltrating the rectum: a randomized trial. Hum Reprod. 2018;33(1):47–57.\nRoman H, Darwish B, Bridoux V, Huet E, Coget J, Chati R, et al. Multiple nodule removal in multifocal colorectal endometriosis instead of ‘en bloc’ large colorectal resection. Gynecol Obstet Fertil. 2016;44(2):121–4.\nSoriano D, Schonman R, Nadu A, Lebovitz O, Schiff E, Seidman DS, et al. Multidisciplinary team approach to management of severe endometriosis affecting the ureter: long-term outcome data and treatment algorithm. J Minim Invasive Gynecol. 2011;18(4):483–8.\nFroc E, Dubernard G, Bendifallah S, Hermouet E, Rubod-Dit-Guillet C, Canis M, et al. Clinical characteristics of urinary tract endometriosis: a one-year national series of 232 patients from 31 endometriosis expert centers (by the FRIENDS group). Eur J Obstet Gynecol Reprod Biol. 2021;264:155–61.\nKeckstein J, Saridogan E, Ulrich UA, Sillem M, Oppelt P, Schweppe KW, et al. The #Enzian classification: a comprehensive non-invasive and surgical description system for endometriosis. Acta Obstet Gynecol Scand. 2021;100:1165.\nHaas D, Chvatal R, Habelsberger A, Wurm P, Schimetta W, Oppelt P. Comparison of revised American fertility society and ENZIAN staging: a critical evaluation of classifications of endometriosis on the basis of our patient population. Fertil Steril. 2011;95(5):1574–8.\nHaas D, Chvatal R, Habelsberger A, Schimetta W, Wayand W, Shamiyeh A, et al. Preoperative planning of surgery for deeply infiltrating endometriosis using the ENZIAN classification. Eur J Obstet Gynecol Reprod Biol. 2013;166(1):99–103.\nPoupon C, Owen C, Arfi A, Cohen J, Bendifallah S, Daraï E. Nomogram predicting the likelihood of complications after surgery for deep endometriosis without bowel involvement. Eur J Obstetr Gynecol Reprod Biol X. 2019;3:100028.\nThomassin-Naggara I, Monroc M, Chauveau B, Fauconnier A, Verpillat P, Dabi Y, et al. Multicenter external validation of the deep pelvic endometriosis index magnetic resonance imaging score. JAMA Netw Open. 2023;6(5):e2311686.\nTomassetti C, Bafort C, Meuleman C, Welkenhuysen M, Fieuws S, D’Hooghe T. Reproducibility of the endometriosis fertility index: a prospective inter−/intra-rater agreement study. BJOG. 2020;127(1):107–14.\nRoman H. Disc excision using Transanal circular stapler for deep endometriosis of the rectum in 10 steps. J Minim Invasive Gynecol. 2021;28(1):14–5.\nAlborzi S, Roman H, Askary E, Poordast T, Shahraki MH, Alborzi S, et al. Colorectal endometriosis: diagnosis, surgical strategies and post-operative complications. Front Surg. 2022;9:978326.\nKostov S, Slavchev S, Dzhenkov D, Mitev D, Yordanov A. Avascular spaces of the female pelvis—clinical applications in obstetrics and gynecology. J Clin Med. 2020;9(5):1460.\nCeccaroni M, Clarizia R, Tebache L. Role and technique of nerve-sparing surgery in deep endometriosis. J Endometriosis Pelvic Pain Disord. 2016;8(4):141–51.\nRoman H, Tuech JJ, Huet E, Bridoux V, Khalil H, Hennetier C, et al. Excision versus colorectal resection in deep endometriosis infiltrating the rectum: 5-year follow-up of patients enrolled in a randomized controlled trial. Hum Reprod. 2019;34(12):2362–71.\nAbo C, Bendifallah S, Jayot A, Nyangoh Timoh K, Tuech J-J, Roman H, et al. Discoid resection for colorectal endometriosis: results from a prospective cohort from two French tertiary referral centres. Colorectal Dis. 2019;21(11):1312–20.\nRoman H, Puscasiu L, Lempicki M, Huet E, Chati R, Bridoux V, et al. Colorectal endometriosis responsible for bowel occlusion or subocclusion in women with pregnancy intention: is the policy of primary in vitro fertilization always safe? J Minim Invasive Gynecol. 2015;22(6):1059–67.\nD’Ancona G, Merlot B, Denost Q, Roman H. Robotic assisted rectal disk excision: the 3 cm-diameter cut off may be abandoned. Fertil Steril. 2023;119(5):886–8.\nNamazov A, Kathurusinghe S, Marabha J, Merlot B, Forestier D, Hennetier C, et al. Double disk excision of large deep endometriosis nodules infiltrating the low and mid rectum: a pilot study of 20 cases. J Minim Invasive Gynecol. 2020;27(7):1482–9.\nBokor A, Hudelist G, Dobó N, Dauser B, Farella M, Brubel R, et al. Low anterior resection syndrome following different surgical approaches for low rectal endometriosis: a retrospective multicenter study. Acta Obstet Gynecol Scand. 2021;100(5):860–7.\nBendifallah S, Puchar A, Vesale E, Moawad G, Daraï E, Roman H. Surgical outcomes after colorectal surgery for endometriosis: a systematic review and meta-analysis. J Minim Invasive Gynecol. 2021;28(3):453–66.\nChapron C, Chiodo I, Leconte M, Amsellem-Ouazana D, Chopin N, Borghese B, et al. Severe ureteral endometriosis: the intrinsic type is not so rare after complete surgical exeresis of deep endometriotic lesions. Fertil Steril. 2010;93(7):2115–20.\nda Cunha FL, Arcoverde FVL, Andres MP, Gomes DC, Bautzer CRD, Abrao MS, et al. Laparoscopic treatment of ureteral endometriosis: a systematic review. J Minim Invasive Gynecol. 2021;28(4):779–87.\nNezhat C, Lavie O, Lemyre M, Unal E, Nezhat CH, Nezhat F. Robot-assisted laparoscopic surgery in gynecology: scientific dream or reality? Fertil Steril. 2009;91(6):2620–2.\nRaimondo D, Borghese G, Mabrouk M, Arena A, Ambrosio M, Del Forno S, et al. Use of Indocyanine green for intraoperative perfusion assessment in women with ureteral endometriosis: a preliminary study. J Minim Invasive Gynecol. 2021;28(1):42–9.\nCrestani A, Dennis T, Roman H. Excision of a deep endometriosis nodule of the bladder (with video). J Visc Surg. 2023;160:74.\nRoman H, Arambage K, Pasquier G, Resch B, Huet E. Combined cystoscopic and laparoscopic approach in deep endometriosis of the bladder. J Minim Invasive Gynecol. 2014;21(6):978–9.\nRoman H, Braund S, Hennetier C, Celhay O, Pasquier G, Kade S, et al. Combined cystoscopic-abdominal versus abdominal-only route for complete excision of large deep endometriosis nodules infiltrating the supratrigonal area of the bladder: a comparative study. J Minim Invasive Gynecol. 2024;31(4):295–303.\nD’Ancona G, Merlot B, Verrelli L, Boulos S, Dennis T, Roman H. Robotic management of isolated endometriosis of sciatic nerve: a reproducible approach that can guide through the labyrinth of pelvic neuroanatomy. Fertil Steril. 2023;120(3, Part 2):703–5.\nLucarini A, Guida AM, Orville M, Panis Y. Indocyanine green fluorescence angiography could reduce the risk of anastomotic leakage in rectal cancer surgery: a systematic review and meta-analysis of randomized controlled trials. Colorectal Dis. 2024;26(3):408–16.\nSibiude J, Santulli P, Marcellin L, Borghese B, Dousset B, Chapron C. Association of history of surgery for endometriosis with severity of deeply infiltrating endometriosis. Obstet Gynecol. 2014;124(4):709–17.\nAuthor information\nAuthors and Affiliations\nEditor information\nEditors and Affiliations\nRights and permissions\nCopyright information\n© 2025 The Author(s), under exclusive license to Springer Nature Switzerland AG\nAbout this chapter\nCite this chapter\nCrestani, A., Merlot, B., Roman, H. (2025). Technique and Reporting of the Imaging Techniques and Classifications: Laparoscopic Surgery. In: Thomassin-Naggara, I. (eds) Imaging of Endometriosis: A Comparative Guide of US, MRI and Surgery. Springer, Cham. https://doi.org/10.1007/978-3-031-82750-1_16\nDownload citation\nDOI: https://doi.org/10.1007/978-3-031-82750-1_16\nPublished:\nPublisher Name: Springer, Cham\nPrint ISBN: 978-3-031-82749-5\nOnline ISBN: 978-3-031-82750-1\neBook Packages: MedicineMedicine (R0)","source_license":"CC0","license_restricted":false}