title: Minimally invasive gynecologic procedures.
abstract: OBJECTIVE
  To evaluate different surgical options for the treatment of endometriomas. A heated debate is currently under way between advocates of excisional surgery and the ablative approach. With papers increasingly focusing on ovarian reserve after endometrioma surgery, a review was mandatory.
  
  
  RESULTS
  Excisional and ablative surgery are well known procedures. This paper describes a combined technique that allows preservation of ovarian volume and antral follicle count. The question of postoperative ovarian reserve is widely discussed and the risk of malignancy is addressed.
  
  
  CONCLUSIONS
  Some previously published reviews have probably too hastily concluded that excision is a better option than ablation. They failed to analyze the ovarian reserve, which is often significantly decreased after excisional surgery.This manuscript clearly explains the crucial importance of preserving the ovarian blood supply, as well as the ovarian cortex containing all primordial follicles, during surgery.
authors.affiliation: Department of Gynecology, Université Catholique de Louvain, Brussels, Belgium. jacques.donnez@uclouvain.be
authors.forename: Jacques
authors.initials: J
authors.lastname: Donnez
authors.forename: Jean
authors.initials: J
authors.lastname: Squifflet
authors.forename: Olivier
authors.initials: O
authors.lastname: Donnez
mesh_terms: D055011:Ablation Techniques; D004715:Endometriosis / Q000209:etiology / Q000628:therapy*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D010049:Ovarian Diseases / Q000628:therapy*; D010051:Ovarian Neoplasms / Q000453:epidemiology*; D010053:Ovary / Q000502:physiology; D015911:Sclerotherapy