Surgical treatment of XXXX .

@entity1 @entity43 @entity14708 @entity4134 @entity6018 @entity2371 @entity1744 @entity46 @entity158 @entity9414 @entity547 @entity2335
In this review, the pitfalls that still exist with the surgical treatment of endometriosisassociatedpelvic @entity158 have been discussed and the best evidence regarding various aspects of surgical techniques have been reviewed. When laparoscopy is performed to evaluate a @entity1 with @entity2371 , it is important she be counseled that the primary function of the surgery is to confirm the presence (and allow surgical treatment) of @entity46 , and that it is not the penultimate diagnostic modality for her @entity2371 . There are many etiologies of @entity2371 that present with symptoms resembling those of @entity2371 that are not diagnosable with laparoscopy, such as @entity2335 and @entity1744 . It is unfortunate that many @entity1 are left with the belief that if a laparoscopy fails to provide a diagnosis of a @entity158 generator, then it means there are no diagnoses other than that the    @entity158 is in her head,    often disparagingly termed    supratentorial    byclinicians. In fact, the @entity158 -related diagnoses that are amenable to and possibly require a laparoscopy are quite limited, a group of diagnoses that this author terms the    dirty dozen    because there are just 12, and only the first 4 have good evidence to clearly associate them with chronic @entity2371 :1. Endometriosis 2. @entity43 3. Pelvic inflammatory disease 4. @entity9414 5. Adhesions 6. @entity6018 7. Postoperative peritoneal cysts 8. @entity4134 (nonendometriotic)9. Chronic ectopic pregnancy 10. @entity14708 11. Residual accessory ovary 12. @entity547 : ventral, inguinal, femoral, spigelian.I would argue that diagnostic laparoscopy in modern gynecology has a limited, if any role, and that when laparoscopy is planned for @entity1 with chronic @entity2371 , it should be with a very high suspicion of a diagnosis and with plans to treat the disease operatively. In this era, a negative diagnostic laparoscopy should be a rare event.
