This video titled "Laparoscopic Salpingo-oophorectomy for Recurrent Endometrioma" offers a comprehensive, real-time demonstration of one of the most effective surgical solutions for managing chronic pelvic pain and recurrent ovarian endometriomas. Performed at World Laparoscopy Hospital, under the guidance of Prof. Dr. R. K. Mishra, this minimally invasive procedure focuses on removing the diseased ovary and fallopian tube in women who have had repeated episodes of symptomatic endometriosis unresponsive to conservative treatments.

Understanding Recurrent Endometrioma

An endometrioma, often referred to as a “chocolate cyst,” is a type of ovarian cyst formed by endometrial tissue. While laparoscopic cystectomy is often the first-line treatment, recurrence rates remain high—especially in women with bilateral involvement, severe adhesions, or deep infiltrating endometriosis. In patients with chronic pain, failed medical therapy, or completed fertility goals, salpingo-oophorectomy (removal of the ovary and fallopian tube) is considered a definitive and curative approach.

Key Surgical Steps Demonstrated in the Video

Diagnostic laparoscopy to evaluate the extent of pelvic endometriosis and adhesions
Adhesiolysis to restore pelvic anatomy and access the adnexal region
Careful dissection around the infundibulopelvic ligament and utero-ovarian pedicle
Securing and transecting the fallopian tube and ovarian vessels using bipolar or advanced energy devices
Safe removal of the adnexa through an endobag to prevent spillage and recurrence
Irrigation and inspection of the pelvic cavity to confirm hemostasis and complete disease clearance

This video highlights the importance of anatomical awareness, meticulous dissection, and energy-based sealing techniques to ensure complete resection with minimal blood loss.

Advantages of Laparoscopic Salpingo-oophorectomy in Recurrent Endometrioma

Definitive resolution of chronic pelvic pain and mass effect
Significant reduction in recurrence risk compared to cystectomy
Minimally invasive approach with small incisions, reduced postoperative pain, and rapid recovery
Precise dissection with preservation of adjacent organs, including ureters and bowel
Improved quality of life, particularly in women with severe endometriosis-related symptoms

Ideal Candidates for the Procedure

Women with recurrent endometrioma after failed conservative or surgical treatment
Patients with severe pelvic pain, dyspareunia, or pressure symptoms
Those with extensive ovarian damage or compromised function
Patients who have completed their family and seek permanent relief
Cases involving unilateral or bilateral salpingo-oophorectomy for deep infiltrating endometriosis

Conclusion

Laparoscopic salpingo-oophorectomy offers a curative approach in managing complex and recurrent cases of ovarian endometriomas, especially when fertility preservation is no longer a priority. As demonstrated in this educational surgical video from World Laparoscopy Hospital, the technique combines precision, safety, and efficiency, making it a gold-standard solution in advanced gynecologic laparoscopy.

Watch the full video to understand the surgical strategy, anatomical considerations, and technical nuances of this important procedure.
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