Laparoscopic Induction of Endometriosis in a Preclinical Swine Model by Autologous Endometrial Transplantation

Pigs are increasingly used as models of human diseases, largely because their anatomy, physiology, and genetics more closely resemble those of humans. Given its relatively high prevalence and incompletely understood pathogenesis, endometriosis is an important condition to model in a large-animal model. This protocol describes the laparoscopic induction of endometriosis in a preclinical swine model via autologous transplantation of endometrial tissue into the peritoneal cavity. Endometrial fragments are isolated shortly after standing estrus, minced into uniform pieces, and optionally labeled ex vivo with fluorescein isothiocyanate (FITC) dye-doped silica nanoparticles to enable fluorescent identification of ectopic lesions. The labeled or unlabeled tissue fragments are reintroduced into the abdominal cavity under sterile surgical conditions. The procedure is then followed by longitudinal monitoring and laparoscopic retrieval of endometriotic lesions. Development and application of a laparoscopic approach that is less invasive than cavity-breaching surgery enables multiple procedures to be performed in the same experimental animal. This large-animal model provides a reproducible, translational platform for studying endometriosis pathophysiology, imaging approaches, and therapeutic interventions.