{"paper_id":"b5b2e7a9-671c-4d27-a1d5-c5439d9a03be","body_text":"Abstract\nThe surgical treatment of endometriosis is in rapid evolution, some would say revolution, owing to advances in microsurgical instrumentation, endoscopic methods, and operative adjuncts including adhesion inhibitors. Standards of treatment are difficult to define, perhaps better referred to as accepted treatment options. This chapter, summarizing one surgeon’s approach to endometriosis surgery, can at best be a snapshot in time of accepted operative methods; in fact, the degree of being accepted varies, as there continues ample controversy regarding optimum treatment of this confusing disease. Hopefully, in 5 to 10 years, some of the principles described in this chapter will seem overly simplistic, much as we now view the previous standard of hysterectomy and castration for all endometriosis patients. The history of endometriosis treatment may provide useful perspective, however, in the ’modern approach’ to surgical treatment. In the following section, a brief overview of historical trends will suggest where surgical treatment is heading, as well as give proper credit to the work of surgeons who pioneered new options in endometriosis therapy.\nPreview\nUnable to display preview. Download preview PDF.\nSimilar content being viewed by others\nReferences\nWheeler, J.M. (1990). The emperor (or, rather, his statistician) has new clothes. Fertil. Steril., 53, 220–223\nSampson, J.A. (1940). Development of the implantation theory of origin of peritoneal endometriosis. Am. J. Obstet. Gynecol., 40, 549–561\nRogers, S.F. and Jacobs, W.M. (1968). Infertility and endometriosis: conservative surgical approach. Fertil Steril., 19, 529–536\nMalinak, L.R. and Wheeler, J.M. (1988). Does mild endometriosis cause infertility? Semin. Reprod. Endo., 6, 239–248\nWheeler, J.M. (1990). The epidemiology of endometriosis-associated infertility. J. Reprod. Med., 34, 41–46\nWheeler, J.M. and Malinak, L.R. (1989). The surgical management of endometriosis. Obstet. Gynecol. Clin. North. Am., 16, 147–156\nHenzl, M.R., Corson, L.L., Moghissi, K.S., Buttram, V.C, Berquist, C. and Jacobson, J. (1988). Administration of nasal nafarelin as compared with oral danazol for endometriosis. N. Engl. J. Med., 318, 485–489\nWheeler, J.M., Malinak, L.R., Miller, J., Knittle, J. and the Depot Lupron study group, (1990). A randomized, placebo controlled comparison of depot leuprolide acetate vs. danazol in the treatment of endometriosis. (Submitted)\nGordon, K., Williams, R.F., Danforth, D.R. and Hodgen, G.D. (1990). Induction of a prolonged hypoestrogenic status in intact primates by Antide (nal-lys): a long-acting GnRH antagonist. Presented at the 37th Annual Meeting of the Society for Gynecologic Investigation, March 21–24, St. Louis, Missouri\nDeCherney, A.H. (1985). The leader of the band is tired. Fertil. Steril., 35, 521–523\nInterceed (TC7) Adhesion Barrier Study Group (1989). Prevention of postsurgical adhesions by Interceed (TC7), an absorbable adhesion barrier: a prospective, randomized multicenter clinical study. Fertil. Steril., 51, 933–938\nDunn, R.C., Steinleitner, A.J. and Lambert, H. (1989). Synergistic effect of calcium channel blockade and recombinant tissue plasminogen activator to prevent adhesions via a continuous intraperitoneal pump. Presented at the 45th Annual Meeting of the American Fertility Society, November 13–16, San Francisco\nSteinleitner, A., Kazensky, C. and Lambert, H. (1990). Prevention of primary posttraumatic adhesion formation by analogs of the neuroendocrine-immunomodulatory peptides substance P (SP) and somatostatin (SMS). Presented at the 37th Annual Meeting of the Society for Gynecologic Investigation, March 21–24, St. Louis, Missouri\nWheeler, J.M. and Malinak, L.R. (1981). Postoperative danazol therapy in infertility patients with severe endometriosis. Fertil Steril., 36, 460–464\nWheeler, J.M., Maccato, M.L. and Malinak, L.R. (1985). Postoperative danazol: pregnancy rates in women with endometriosis treated by combined conservative surgical therapy/immediate postoperative danazol. Presented at the 41st Annual Meeting of the American Fertility Society, September 28–30, Chicago\nMurphy, A.A., Green, W.R., Bobbie, D. and Rock, J.A. (1986). Unsuspected endometriosis documented by scanning electron microscopy in visually normal peritoneum. Fertil Steril., 46, 522–526\nStripling, M.C., Martin, D.C., Chatman, D.L., VanderZwaag, R. and Poston, W.M. (1988). Subtle appearance of pelvic endometriosis. Fertil. Steril., 49, 427–431\nThe American Fertility Society (1985). Revised American Fertility Society classification of endometriosis. Fertil. Steril., 43, 351–352\nSemm, K. (1987). Operative manual for endoscopic abdominal surgery. (Chicago: Year Book Medical Publishers)\nLinsky, C. and Bardi, J.A. (1990). Personal communication.\nMaccatto, M.L., Wheeler, J.M. and Malinak, L.R. (1985). The timing of laparoscopy to laparotomy in the surgical treatment of female infertility. Presented at the 33rd Annual Clinical Meeting of the American College of Obstetricians and Gynecologists. May 20–24, Washington, D.C.\nMalinak, L.R. and Wheeler, J.M. (1987). Presacral neurectomy. In Garcia, C.-R., Mikata, J.J. and Rosenblum, N. (eds.) Current Therapy in Surgical Gynecology, pp. 70–91. (Toronto: BC Decker)\nWheeler, J.M. and Malinak, L.R. (1990). Combined medical and surgical therapy for endometriosis. Prog. Clin. Biol. Res., 323, 281–288\nWheeler, J.M. and Malinak, L.R. (1987). Computer graphic pelvic mapping, second-look laparoscopy, and the distinction of recurrent vs. persistent endometriosis. Presented at the 43rd Annual Meeting of the American Fertility Society, September 28–30, Reno, Nevada\nEditor information\nEditors and Affiliations\nRights and permissions\nCopyright information\n© 1991 Springer Science+Business Media Dordrecht\nAbout this chapter\nCite this chapter\nWheeler, J.M. (1991). Macro- and microsurgical treatment of endometriosis. In: Thomas, E.J., Rock, J.A. (eds) Modern Approaches to Endometriosis. Springer, Dordrecht. https://doi.org/10.1007/978-94-011-3864-2_10\nDownload citation\nDOI: https://doi.org/10.1007/978-94-011-3864-2_10\nPublisher Name: Springer, Dordrecht\nPrint ISBN: 978-94-010-5719-6\nOnline ISBN: 978-94-011-3864-2\neBook Packages: Springer Book Archive\nKeywords\n- GnRH Agonist\n- Laparoscopic Treatment\n- Endometriosis Patient\n- American Fertility Society\n- Microsurgical Treatment\nThese keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.","source_license":"CC0","license_restricted":false}