A new approach to avoid ovarian failure as well function-impairing adhesion formation in endometrioma infertility surgery



Deep ovarian endometriosis surgery is likely to be associated with diffuse bleeding, intraoperative ovarian tissue destruction and perioperative adhesion formation. A new surgical approach is hereby proposed to avoid the negative short-term impact of classic laparoscopic cystectomy on ovarian reserve.


The need for intraoperative periovarian coagulation after endometrioma excision was avoided by combining the gold standard minimal-access endometrioma stripping technique with a purely plant-based medical product with high-hemostatic and antiadhesion barrier properties.


Endometrioma stripping followed by the application of a polysaccharide agent could avoid ovarian failure and at same time could reduce adhesion formation, thereby preserving tubo-ovarian function in endometrioma surgery. We encourage other surgically working groups to investigate middle- and long-term effects of this combined technique.

This is a preview of subscription content, access via your institution.

Fig. 1


  1. 1.

    Asgari Z, Rouholamin S, Hosseini R, Sepidarkish M, Hafizi L, Javaheri A (2016) Comparing ovarian reserve after laparoscopic excision of endometriotic cyst and hemostasis achieved either by bipolar coagulation or suturing: a randomized clinical trial. Arch Gynecol Obstet 293:1015–1022. https://doi.org/10.1007/s00404-015-3918-4

    Article  PubMed  Google Scholar 

  2. 2.

    Hirschelmann A, Tchartchian G, Wallwiener M, Hackethal A, Wilde De RL (2012) A review of the problematic adhesion prophylaxis in gynaecological surgery. Arch Gynecol Obstet 285:1089–1097. https://doi.org/10.1007/s00404-011-2097-1

    Article  PubMed  Google Scholar 

  3. 3.

    Korell M, Ziegler N, Wilde De RL (2016) Use of modified polysaccharide 4DryField (®) PH for adhesion prevention and hemostasis in gynecological surgery: a two-center observational study by second-look laparoscopy. Biomed Res Int 1–9 https://doi.org/10.1155/2016/3029264

    Article  PubMed  PubMed Central  Google Scholar 

  4. 4.

    Hart RJ, Hickey M, Maouris P, Buckett W (2008) Excisional surgery versus ablative surgery for ovarian endometriomata. Cochrane Database Syst Rev 2:CD004992. https://doi.org/10.1002/14651858.CD004992

    Article  Google Scholar 

Download references


The funding was provided by PlanTec Medical GmBH (Germany) (Grant No. 2018).

Author information




All authors contributed to the paper conception and design. The first draft of the manuscript was written by LATR and RD and all authors commented on and reviewed the following versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Rudy Leon De Wilde.

Ethics declarations

Conflict of interest

Dr. De Wilde reports personal fees from PlanTec Medical GmbH, Bad Bevesen, Germany, outside the submitted work. The authors have received a reimbursement travel by PlanTec Medical GmBH, Bad Bevensen, Germany, to present these data during an international congress. However, the financial support for this work did not influence its outcome.

Ethical approval

Procedures performed involving human participants were in accordance with the ethical standards of the institution.

Informed consent

Informed consent was obtained from individual participants prior to surgery.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Torres-de la Roche, L.A., Devassy, R., de Wilde, M.S. et al. A new approach to avoid ovarian failure as well function-impairing adhesion formation in endometrioma infertility surgery. Arch Gynecol Obstet 301, 1113–1115 (2020). https://doi.org/10.1007/s00404-020-05483-9

Download citation


  • Ovarian cyst surgery
  • Minimal invasive surgical procedures
  • Peritoneal adhesions
  • Modified polysaccharide agent