Invasive treatment is the most important part of treatment and involves hysteroscopy and laparoscopic or robotic surgical removal of the endometriosis. Minimally invasive methods are surgical treatments of choice as through small holes in the skin of the abdomen, complete removal of the disease can be achieved, causing minimal post-operative pain, rapid recovery and return to daily life and optimal aesthetic results. Open surgery has been almost completely abandoned.
Surgeries for Endometriosis and especially deep infiltrative Endometriosis are admittedly the most demanding surgeries in Gynecology and therefore require specialization. The Gynaecologist must be familiar with the spaces of the retroperitoneal cavity and the anatomy of the pelvis to be able to access these structures, identify the abnormal foci and remove them without injuring the underlying nerves and vessels in the area. In fact, research has shown that when these surgeries are performed by Gynaecologists specialised in Endometriosis then patients get the maximum benefit resulting in improved symptoms, fertility and avoiding more surgeries in the future due to endometriosis.