O&G · Gynaecological health — chronic pelvic pain and endometriosis

Endometriosis surgical management: excision vs ablation, DIE, ENZIAN, nerve-sparing

Also known as Laparoscopic excision of endometriosis · Endometrioma cystectomy · Deep infiltrating endometriosis surgery · DIE surgery · Nerve-sparing endometriosis surgery · ENZIAN classification · Segmental bowel resection endometriosis

Exam-exhaustive FRANZCOG fellowship topic on the surgical management of endometriosis: the indications for surgery, laparoscopy as the preferred route, the excision-vs-ablation evidence (equivalent for minimal-to-mild peritoneal disease; excision preferred for DIE and fibrotic nodules), the ENZIAN classification of deep infiltrating endometriosis (DIE) with compartments A/B/C/FA/FB/FU/FI and severity grades, the multidisciplinary approach to bowel/bladder/ureter disease (shaving, discoid, segmental), nerve-sparing surgery, the endometrioma and ovarian-reserve trade-off, the recurrence rate of 20-40% at 5 years, and the fertility-sparing surgical outcomes by the EFI. RANZCOG-primary (Australian Living Evidence), globally tagged to ESHRE 2022, MRCOG, ABOG, FRCSC and MRCPI.