OC069: Sonographic evaluation of residual functioning ovarian tissue after laparoscopic removal of endometriomas

The use of the laparoscopic approach, in particular the “stripping” technique, has been questioned because it may involve excessive removal of ovarian tissue with loss of follicles. The aim of this study was to determine how and if the laparoscopic removal of ovarian endometriotic cysts is a tissue-sparing procedure. 52 premenopausal patients with ovarian endometriomas, diagnosed by sonography and confirmed by histology, underwent laparoscopic removal by “stripping”. Within one week prior to surgery all recruited patients underwent TVS evaluation of the endometriotic cyst and measurement of the surrounding ovarian cortex including ovarian volume, size and morphology. Within 6–12 months after laparoscopic excision, TVS measurements of residual ovarian tissues were performed. Mean cyst diameter was 4.7 ± 2.2 cm (range 2.1–9.2 cm). Ovarian residual cortex volume after surgery was significantly less than the previous evaluation of normal ovarian tissue surrounding the endometrioma (10.7 ± 9.2 vs 5.5 ± 4.7 cm3). Although laparoscopic approach is the least invasive technique to treat ovarian endometriosis, it appears aggressive in terms of injuring the residual ovarian tissue.