Pioneering a new era in the treatment of deep infiltrating endometriosis through robotic surgery

15 Copyright © 2025 Society of Korean Robotic Gynecologic Surgery Editorial eISSN 2672-1481 https://doi.org/10.36637/grs.2025.00045 Gyne Robot Surg 2025;6(2):15-16 • Received: September 4, 2025 • Accepted: September 5, 2025 • Corresponding author: Sa Ra Lee Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea E-mail: [email protected] This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/ licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Surgical treatment of endometriosis is a highly challeng- ing and often controversial area from the perspective of gynecologic surgeons. The surgical indications vary depending on the extent of disease - from cases confined to ovarian endometriomas to deeply infiltrating lesions involving surrounding organs. There is also considerable debate among surgeons regard- ing the extent of surgery required. Furthermore, there are ongoing discussions about whether surgery should be re- placed or complemented by medical therapy. The purpose of surgery can also differ: whether it's for symptom relief, differentiation from malignancy, or maximal excision of lesions, each objective results in a different sur- gical approach. When the goal is maximal excision of lesions, access to the retroperitoneum becomes essential, requiring in-depth knowledge and experience in handling the ureters, nerves, and blood vessels. Robotic surgery is considered the most ideal approach for such complex cases, and for this reason, the Society of Korean Robotic Gynecologic Surgery has organized a spe- cial workshop on deep infiltrating endometriosis (DIE). The Society of Korean Robotic Gynecologic Surgery and the Pelvic Nerve Study Group jointly hosted a special work- shop on August 31, 2025. This workshop, titled “Deep Infil- trating Endometriosis, Nerve and Surgical Innovation”, was organized to share practical techniques and insights that can be directly applied in clinical practice. A key focus was the essential neuroanatomical under - standing required for DIE surgery, including lectures on the concept of neuropelviology and the distinction between autonomic and somatic nerves. The program also covered radiological approaches, including ultrasound and magnetic resonance imaging findings for DIE, and offered in-depth discussions on surgical strategies. Moreover, through the clinical experiences of leading do- mestic experts, participants gained practical guidance on laparoscopic and robotic surgical approaches for various in- tra-abdominal DIE lesions, as well as postoperative man- agement strategies. Finally, there was a valuable session featuring professor Marc Possover, where participants had the rare opportuni- ty to learn and discuss the pelvic nerve research achieve- Pioneering a new era in the treatment of deep infiltrating endometriosis through robotic surgery Sa Ra Lee Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Key Words: Endometriosis; Nervous system; Pelvic pain; Robotic surgical procedures Gynecologic Robotic Surgery | Vol 6, No. 2, September 2025 https://doi.org/10.36637/grs.2025.00045 16 ments he has dedicated his life to - such as Laparoscopic Neuro-Navigation (LANN) and Laparoscopic Implantation of Neuroprosthesis (LION) procedures. For patients living with DIE, the future looks more hope- ful than ever. Robotic surgery is not merely an addition to our surgical armamentarium. It is a transformative tool that may redefine the standard of care in endometriosis man- agement.