{"paper_id":"c3a3b556-474d-4a9f-9ff8-1194b8fc91e2","body_text":"Abstract\nPurpose\nDeep ovarian endometriosis surgery is likely to be associated with diffuse bleeding, intraoperative ovarian tissue destruction and perioperative adhesion formation. A new surgical approach is hereby proposed to avoid the negative short-term impact of classic laparoscopic cystectomy on ovarian reserve.\nResults\nThe need for intraoperative periovarian coagulation after endometrioma excision was avoided by combining the gold standard minimal-access endometrioma stripping technique with a purely plant-based medical product with high-hemostatic and antiadhesion barrier properties.\nConclusion\nEndometrioma stripping followed by the application of a polysaccharide agent could avoid ovarian failure and at same time could reduce adhesion formation, thereby preserving tubo-ovarian function in endometrioma surgery. We encourage other surgically working groups to investigate middle- and long-term effects of this combined technique.\nReferences\nAsgari Z, Rouholamin S, Hosseini R, Sepidarkish M, Hafizi L, Javaheri A (2016) Comparing ovarian reserve after laparoscopic excision of endometriotic cyst and hemostasis achieved either by bipolar coagulation or suturing: a randomized clinical trial. Arch Gynecol Obstet 293:1015–1022. https://doi.org/10.1007/s00404-015-3918-4\nHirschelmann A, Tchartchian G, Wallwiener M, Hackethal A, Wilde De RL (2012) A review of the problematic adhesion prophylaxis in gynaecological surgery. Arch Gynecol Obstet 285:1089–1097. https://doi.org/10.1007/s00404-011-2097-1\nKorell M, Ziegler N, Wilde De RL (2016) Use of modified polysaccharide 4DryField (®) PH for adhesion prevention and hemostasis in gynecological surgery: a two-center observational study by second-look laparoscopy. Biomed Res Int 1–9 https://doi.org/10.1155/2016/3029264\nHart RJ, Hickey M, Maouris P, Buckett W (2008) Excisional surgery versus ablative surgery for ovarian endometriomata. Cochrane Database Syst Rev 2:CD004992. https://doi.org/10.1002/14651858.CD004992\nFunding\nThe funding was provided by PlanTec Medical GmBH (Germany) (Grant No. 2018).\nAuthor information\nAuthors and Affiliations\nContributions\nAll authors contributed to the paper conception and design. The first draft of the manuscript was written by LATR and RD and all authors commented on and reviewed the following versions of the manuscript. All authors read and approved the final manuscript.\nCorresponding author\nEthics declarations\nConflict of interest\nDr. De Wilde reports personal fees from PlanTec Medical GmbH, Bad Bevesen, Germany, outside the submitted work. The authors have received a reimbursement travel by PlanTec Medical GmBH, Bad Bevensen, Germany, to present these data during an international congress. However, the financial support for this work did not influence its outcome.\nEthical approval\nProcedures performed involving human participants were in accordance with the ethical standards of the institution.\nInformed consent\nInformed consent was obtained from individual participants prior to surgery.\nAdditional information\nPublisher's Note\nSpringer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.\nRights and permissions\nAbout this article\nCite this article\nTorres-de la Roche, L.A., Devassy, R., de Wilde, M.S. et al. A new approach to avoid ovarian failure as well function-impairing adhesion formation in endometrioma infertility surgery. Arch Gynecol Obstet 301, 1113–1115 (2020). https://doi.org/10.1007/s00404-020-05483-9\nPublished:\nVersion of record:\nIssue date:\nDOI: https://doi.org/10.1007/s00404-020-05483-9","source_license":"CC0","license_restricted":false}