Feasibility study of a S-shaped incision technique in endometrioma surgery: Cold dissection with no thermal injury

Abolfazl Mehdizadeh, Shahla Chaichian, Marziyeh Ajdary, Arash Mohazzab
Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology · 2026 · vol. 46(1) , pp. 2757461 · doi:10.1080/01443615.2026.2757461 · PMID:42975319 · W7225197605
Other OA: gold public-domain-us
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A pilot study of twelve patients demonstrated that an S-shaped incision with cold dissection for endometrioma surgery is technically feasible and safe, preserving ovarian reserve markers without thermal injury.

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Abstract

Preserving ovarian reserve while minimising recurrence remains a major challenge in endometrioma surgery. Conventional bipolar excision may cause thermal injury to the ovarian cortex and impair fertility potential. We conducted a pilot feasibility study of a technical modification of laparoscopic cystectomy using an S-shaped incision at the ovarian hilum with cold dissection to reduce thermal exposure and cortical damage. Twelve patients underwent cystectomy with this approach, and all procedures were completed without intraoperative complications. Postoperative evaluation included serum anti-Müllerian hormone (AMH), antral follicle count (AFC), pain score, CA-125, and sonographic assessment. Early postoperative findings were compatible with short-term technical feasibility and safety in this small initial series. The observed postoperative changes in ovarian reserve markers and symptoms provide preliminary data to inform future comparative studies with longer follow-up.

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MeSH descriptors

Endometriosis Endometriosis Endometriosis Laparoscopy Laparoscopy Laparoscopy Adult Adult Dissection Dissection Dissection Feasibility Studies Feasibility Studies Female Female Humans Humans Ovarian Reserve Ovarian Reserve Ovary

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References (9)

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