Surgery in Restorative Reproductive Medicine

In: Journal of Restorative Reproductive Medicine · 2025 · vol. 1 , pp. 1–4 · doi:10.63264/v8yt9r80 · W4409619776
article OA: hybrid CC0
AI-generated summary by claude@2026-06, 2026-06-08

Restorative reproductive surgery for endometriosis removes disease and optimizes anatomy, leading to reduced symptoms, high fertility rates, and improved patient quality of life.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

AI-generated deep summary by claude@2026-06, 2026-06-10 · read from full text

This paper discusses restorative reproductive medicine and emphasizes restorative reproductive surgery—highlighting optimal excision of endometriosis and pelvic adhesion prevention—as an approach aimed at removing disease and optimizing reproductive anatomy rather than relying only on IVF. It presents reported links between optimal excision/adhesion prevention and reduced symptoms, higher natural fertility rates, lower need for repeat surgery, and improved quality of life across pregnancies, while acknowledging the need for additional resources, training, advocacy, research, and publication. A key caveat is that the piece is largely a narrative overview rather than a new primary study with methods, quantified results, or explicit inclusion/exclusion criteria. This paper is centrally about endometriosis — it focuses on how optimal excision and adhesion-prevention strategies in restorative reproductive surgery relate to symptoms and fertility outcomes in endometriosis.

Read from the paper's body, not the abstract. Not a substitute for reading the paper. No clinical advice. How this works

Abstract

Restorative reproductive surgery has emerged to become an exciting and promising field of surgery that can transform the way that we treat patients, especially regarding fertility. As a prime example of this type of surgery, restorative reproductive surgery for endometriosis, a common and debilitating disease that can lead to infertility and pelvic pain, offers a root cause treatment to remove the actual disease and to optimize the reproductive anatomy, for best patient outcomes. Optimal excision of endometriosis and prevention of pelvic adhesions has been shown to lead to reduce symptoms, to lead to high natural fertility rates, and to lead to very low rates of the need for repeat surgery. Patients have improved symptoms and quality of life, in addition to improved fertility chances for one and subsequent pregnancies (if desired), demonstrating the link between wellness and fertility. There is an urgent need for more resources, training, advocacy, research and publication for this exciting area of restorative reproductive surgery. Its time has come.
Full text 10,414 characters · extracted from oa-doi-fallback · click to expand
Surgery in Restorative Reproductive Medicine DOI: https://doi.org/10.63264/v8yt9r80Keywords: surgery, restorative surgery, restorative reproductive medicine, alternatives to IVF, optimal excision, adhesion preventionAbstract Restorative reproductive surgery has emerged to become an exciting and promising field of surgery that can transform the way that we treat patients, especially regarding fertility. As a prime example of this type of surgery, restorative reproductive surgery for endometriosis, a common and debilitating disease that can lead to infertility and pelvic pain, offers a root cause treatment to remove the actual disease and to optimize the reproductive anatomy, for best patient outcomes. Optimal excision of endometriosis and prevention of pelvic adhesions has been shown to lead to reduce symptoms, to lead to high natural fertility rates, and to lead to very low rates of the need for repeat surgery. Patients have improved symptoms and quality of life, in addition to improved fertility chances for one and subsequent pregnancies (if desired), demonstrating the link between wellness and fertility. There is an urgent need for more resources, training, advocacy, research and publication for this exciting area of restorative reproductive surgery. Its time has come. References 1. Duffy J, et al. Laparoscopic surgery for endometriosis. Cochrane Database Syst Rev. 2014 Apr 3;(4):CD011031. https://doi.org/10.1002/14651858.CD011031.pub2. DOI: https://doi.org/10.1002/14651858.CD011031.pub2 2. Hilgers, TW. Near Adhesion-Free Reconstructive Pelvic Surgery: Three Distinct Phases of Progress Over 23 Years. J. Gynecol. Surg. 2010;26(1):31-40. https://doi.org/10.1089/gyn.2009.0031. DOI: https://doi.org/10.1089/gyn.2009.0031 3. Hilgers TW, Yeung P. Intratubal pressure before and after transcervical catheterization of the fallopian tubes. Fertil Steril. 1999 Jul;72(1):174-8. https://doi.org/10.1016/s0015-0282(99)00165-x. DOI: https://doi.org/10.1016/S0015-0282(99)00165-X 4. Kasia JM, Ngowa JD, et al. Laparoscopic Fimbrioplasty and Neosalpingostomy in Female Infertility. J Reprod Infertil. 2016 Apr-Jun;17(2):104-9. 5. Gomel V. The place of reconstructive tubal surgery in the era of assisted reproductive techniques. Reprod Biomed Online. 2015 Dec;31(6):722-31. https://doi.org/10.1016/j.rbmo.2015.09.010. DOI: https://doi.org/10.1016/j.rbmo.2015.09.010 6. Su H, et al. Restoring tubal patency with laparoscopic tubocornual anastomosis. Taiwan J Obstet Gynecol. 2022 Sep;61(5):858-862. https://doi.org/10.1016/j.tjog.2021.10.009. DOI: https://doi.org/10.1016/j.tjog.2021.10.009 7. van Seeters JAH, Chua SJ, Mol BWJ, Koks CAM. Tubal anastomosis after previous sterilization: a systematic review. Hum Reprod Update. 2017 May 1;23(3):358-370. https://doi.org/10.1093/humupd/dmx003. DOI: https://doi.org/10.1093/humupd/dmx003 8. Amer SA, et al. Long term follow-up of patients with polycystic ovarian syndrome after laparoscopic ovarian drilling. Hum Reprod. 2002 Aug;17(8):2035-42. https://doi.org/10.1093/humrep/17.8.2035. DOI: https://doi.org/10.1093/humrep/17.8.2035 9. Yildirim M, Noyan V, et al. Ovarian wedge resection by minilaparotomy in infertile patients with polycystic ovarian syndrome: a new technique. Eur J Obstet Gynecol Reprod Biol. 2003 Mar 26;107(1):85-7. https://doi.org/10.1016/s0301-2115(02)00348-2. DOI: https://doi.org/10.1016/S0301-2115(02)00348-2 10. Duleba AJ, Banaszewska B, et al. Success of laparoscopic ovarian wedge resection is related to obesity, lipid profile, and insulin levels. Fertil Steril. 2003 Apr;79(4):1008-14. https://doi.org/10.1016/s0015-0282(02)04848-3. DOI: https://doi.org/10.1016/S0015-0282(02)04848-3 11. Kalaitzopoulos DR, Themeli MZ, et al. Fertility, pregnancy and perioperative outcomes after operative hysteroscopy for uterine septum. Arch Gynecol Obstet. 2024 Mar;309(3):731-744. https://doi.org/10.1007/s00404-023-07109-2. DOI: https://doi.org/10.1007/s00404-023-07109-2 12. Baldini GM, Lot D, Malvasi A. Isthmocele and Infertility. J Clin Med. 2024 Apr 10;13(8):2192. https://doi.org/10.3390/jcm13082192. DOI: https://doi.org/10.3390/jcm13082192 13. Jensen CFS, et al. Varicocele and male infertility. Nat Rev Urol. 2017 Sep;14(9):523-533. https://doi.org/10.1038/nrurol.2017.98. DOI: https://doi.org/10.1038/nrurol.2017.98 14. Della Corte L, et al. The Burden of Endometriosis on Women's Lifespan. Int J Environ Res Public Health. 2020 Jun 29;17(13):4683. https://doi.org/10.3390/ijerph17134683. DOI: https://doi.org/10.3390/ijerph17134683 15. Darbà J, Marsà A. Economic Implications of Endometriosis: A Review. Pharmacoeconomics. 2022 Dec;40(12):1143-1158. https://doi.org/10.1007/s40273-022-01211-0. DOI: https://doi.org/10.1007/s40273-022-01211-0 16. Harris A, Tsaltas J. Endometriosis and infertility: a systematic review. J Endometr Pelvic Pain Disord. 2017 Jul;9(3):139-149. https://doi.org/10.5301/jeppd.5000296. DOI: https://doi.org/10.5301/jeppd.5000296 17. Hadfield R, Mardon H. Delay in the diagnosis of endometriosis. Hum Reprod. 1996 Apr;11(4):878-80. https://doi.org/10.1093/oxfordjournals.humrep.a019270. DOI: https://doi.org/10.1093/oxfordjournals.humrep.a019270 18. Arruda MS, et al. Time elapsed from onset of symptoms to diagnosis of endometriosis. Hum Reprod. 2003 Apr;18(4):756-9. https://doi.org/10.1093/humrep/deg136. DOI: https://doi.org/10.1093/humrep/deg136 19. Brown J, Farquhar C. Endometriosis: an overview of Cochrane Reviews. Cochrane Database Syst Rev. 2014 Mar 10;2014(3):CD009590. https://doi.org/10.1002/14651858.CD009590.pub2. DOI: https://doi.org/10.1002/14651858.CD009590.pub2 20. Yeung P Jr, Sinervo K, et al. Complete laparoscopic excision of endometriosis in teenagers. Fertil Steril. 2011 May;95(6):1909-12, 1912.e1. https://doi.org/10.1016/j.fertnstert.2011.02.037. DOI: https://doi.org/10.1016/j.fertnstert.2011.02.037 21. Rindos NB, Fulcher IR, Donnellan NM. Pain and Quality of Life after Laparoscopic Excision of Endometriosis. J Minim Invasive Gynecol. 2020 Nov-Dec;27(7):1610-1617.e1. https://doi.org/10.1016/j.jmig.2020.03.013. DOI: https://doi.org/10.1016/j.jmig.2020.03.013 22. Arcoverde FVL, et al. Surgery for Endometriosis Improves Major Domains of Quality of Life: A Systematic Review and Meta-Analysis. J Minim Invasive Gynecol. 2019 Feb;26(2):266-278. https://doi.org/10.1016/j.jmig.2018.09.774. DOI: https://doi.org/10.1016/j.jmig.2018.09.774 23. Yeung, P, Mohan A, Gavard J. The Long-term Rate of Repeat Surgery After Optimal Excision Surgery of Endometriosis. Acta Scientific Women’s Health. 2024 Sept;7(1):10. https://doi.org/10.20944/preprints202409.1485.v1. DOI: https://doi.org/10.20944/preprints202409.1485.v1 24. Yeung PP Jr, Logan I, Gavard JA. Deep Retraction Pockets, Endometriosis, and Quality of Life. Front Public Health. 2016 May 9;4:85. https://doi.org/10.3389/fpubh.2016.00085. DOI: https://doi.org/10.3389/fpubh.2016.00085 25. Gupta S. Endometriosis in Hydatid Cysts of Morgagni. J Minim Invasive Gynecol. 2017 May-Jun;24(4):653-658. https://doi.org/10.1016/j.jmig.2017.02.011. DOI: https://doi.org/10.1016/j.jmig.2017.02.011 26. Kennedy S, et al. ESHRE guideline for the diagnosis and treatment of endometriosis. Hum Reprod. 2005 Oct;20(10):2698-704. https://doi.org/10.1093/humrep/dei135. DOI: https://doi.org/10.1093/humrep/dei135 27. Singh SS, Suen MW. Surgery for endometriosis: beyond medical therapies. Fertil Steril. 2017 Mar;107(3):549-554. https://doi.org/10.1016/j.fertnstert.2017.01.001. DOI: https://doi.org/10.1016/j.fertnstert.2017.01.001 28. Pundir J, et al. Laparoscopic Excision Versus Ablation for Endometriosis-associated Pain. J Minim Invasive Gynecol. 2017 Jul-Aug;24(5):747-756. https://doi.org/10.1016/j.fertnstert.2017.01.001. DOI: https://doi.org/10.1016/j.jmig.2017.04.008 29. Panvino F, et al. Endometriosis in Adolescence: A Narrative Review. Diagnostics (Basel). 2025 Feb 24;15(5):548. https://doi.org/10.3390/diagnostics15050548. DOI: https://doi.org/10.3390/diagnostics15050548 30. Yeung PP Jr, Shwayder J, Pasic RP. Laparoscopic management of endometriosis: comprehensive review of best evidence. J Minim Invasive Gynecol. 2009 May-Jun;16(3):269-81. https://doi.org/10.1016/j.jmig.2009.02.007. DOI: https://doi.org/10.1016/j.jmig.2009.02.007 31. Takenaka M, et al. Exploratory study of pre-surgical medications with dienogest or leuprorelin in laparoscopic cystectomy of endometrial cysts. J Obstet Gynaecol Res. 2015 Aug;41(8):1234-9. https://doi.org/10.1111/jog.12701. DOI: https://doi.org/10.1111/jog.12701 32. Sutton CJ, Ewen SP, Whitelaw N, Haines P. Prospective, randomized, double-blind, controlled trial of laser laparoscopy in the treatment of pelvic pain associated with endometriosis. Fertil Steril. 1994 Oct;62(4):696-700. https://doi.org/10.1016/s0015-0282(16)56990-8. DOI: https://doi.org/10.1016/S0015-0282(16)56990-8 33. Vitale SG, et al. Sexual Function and Quality of Life in Patients Affected by Deep Infiltrating Endometriosis. J Endometr Pelvic Pain Disord. 2018;9(4):270-274. https://doi.org/10.5301/jeppd.5000303. DOI: https://doi.org/10.5301/jeppd.5000303 34. Yeung, PP, Jr., et al. Fertility after expanded polytetrafluoroethylene use after endometrioma cystectomy: a pilot study. Front Reprod Health. 2023;5:1231029. https://doi.org/10.3389/frph.2023.1231029. DOI: https://doi.org/10.3389/frph.2023.1231029 35. AAGL Advancing Minimally Invasive Gynecology Worldwide. AAGL position statement: route of hysterectomy to treat benign uterine disease. J Minim Invasive Gynecol. 2011 Jan-Feb;18(1):1-3. https://doi.org/10.1016/j.jmig.2010.10.001. DOI: https://doi.org/10.1016/j.jmig.2010.10.001 36. Meuleman C, et al. Laparoscopic treatment of endometriosis. Minerva Ginecol. 2013 Apr;65(2):125-142. PMID: 23598780. 37. Koninckx PR, Ussia A. “Centers of excellence in endometriosis surgery” or “centers of excellence in endometriosis”. Gynecological Surgery. 2010;7(2):109-111. https://doi.org/10.1007/s10397-009-0549-4. DOI: https://doi.org/10.1007/s10397-009-0549-4 Published Issue Section Categories License Copyright (c) 2025 Patrick Yeung, Jr. This work is licensed under a Creative Commons Attribution 4.0 International License. CC-BY-4.0 permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made.

Text is read by the "Ask this paper" AI Q&A widget below. Extraction quality varies by source — PMC NXML preserves structure cleanly, OA-HTML may include some navigation residue, and OA-PDF can have broken hyphenation. The publisher copy (via DOI) is the canonical version.

My notes (saved in your browser only)

Ask this paper AI returns verbatim quotes from the full text · source: oa-doi-fallback

Answers must be backed by verbatim quotes from this paper's full text. Hallucinated quotes are dropped automatically; if no verbatim passage answers the question, we say so. How this works

Condition tags

endometriosisinfertility

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (35)

Source provenance

openalex
last seen: 2026-06-04T00:00:01.174412+00:00
License: CC0 · commercial use OK