P28.01: Ultrasound based staging system as a preoperative triage tool for laparoscopic treatment of endometriosis

To correlate an ultrasound based staging system for endometriosis with the level of laparoscopic training required for endoscopic management. Review of 200 patients with complete ultrasound and surgical data. Based on ultrasonographic features, a 4 stage preoperative staging system was developed that allows immediate comprehension of severity of disease expected at laparoscopy. Components of the stages were inclusive of phenotypes of endometriosis. All patients were retrospectively staged. Surgical reports of all patients were reviewed. Using the Society of Reproductive Surgeons (1994) recommendations on stratification of laparoscopic procedures according to levels of training required, all patients were retrospectively assigned one of three levels based on type of endometriosis related procedure performed. (table 1). The ultrasonographic stages were then correlated with the levels of laparoscopic training required. P28.01: Table 1. Overall, there was substantial agreement (Cohan's kappa 0.70) between the ultrasound stages and level of training required for maximum cyto reduction. Accuracy of predicting exact level of endoscopic training was 82.5%. Sensitivity and positive predictive value for predicting the need for levels 3 and 1 were 88.5% and 80.7%; 93.9% and 92.6%, respectively. This ultrasound based staging system may have a role in the preoperative triage of women with higher stage endometriosis.