Trina Mansour, MD, emphasizes surgical strategies for the treatment of endometriosis

At the American College of Obstricians and Gynecologists 2025 annually and scientific meetings, Trina Mansour, MD, a gynecological surgeon from the Phoenix VA health system, presents the surgical management of endometriosis. Their session focused on the identification and safe exclusion of endometriosis and offered guidelines to improve surgical results through a structured approach.

Development of a structured surgical strategy

“Our presentation deals with the safe excision and identification of endometriosis, essentially only the surgical management of endometriosis,” said Mansour. She emphasized how important it is to record the spectators on a journey from the presentation of patients to the operation or different types of surgical modalities [are] Available, platforms available and then at the time of the operation tips and tricks to support efficient and secure consumption tax. “

According to Mansour, success in endometriosis surgery requires methodological technology. “It must be a systematic approach. To do the same for every single case to really identify these atypical lesions, especially in the areas that we usually do not rate,” she said.

Starting with a comprehensive overview of the upper abdomen and clockwise – “on the left side, then to the intestine, then going to the pelvis”, it recommended that to concentrate on the pool region. This ensures that no atypical lesions are overlooked.

Recognizing atypical presentations of endometriosis

Endometriosis may not always appear in typical forms, which makes surgical identification more difficult. Mansour advised the clinicians to “familiarize themselves through research by surgical libraries”, since “there are more and more research on atypical phenomena of endometriosis”. She added: “I always recommend to breathe suspicious lesions, although it may not be the typical burning of powder, as this contributes to increasing trust in the identification of these atypical phenomena and ensuring that we completely undress the diseases.”

Restrictions on non -invasive diagnosis

“At the moment there are no non -invasive tests on endometriosis,” said Mansour, confirming that “the gold standard can carry out the operation with excision and confirm the diagnosis.” While the receptivadx test is a laboratory instrument, it is mainly used in patients who are subjected to an infertility assessment and is not generally applicable.

Instead, imaging instructions offer a promise. “The most up -and -coming tool is really advanced imaging and targeted imaging,” said Mansour. For example, if a patient reports the right upper quadrant pain in harmony with endometriosis, a targeted ultrasound or an MRI with endometrosis -specific protocols can contribute to the identification of a deep infiltrating disease. However, she admitted, “there are still many studies and research, but that is currently an emerging instrument for patients.”

The selection of the surgical platform depends on the context

Mansour explained that “it really depends on the extent of the disease, the available platform and surgeon competence” when selecting between robotic and laparoscopic approaches. “In the right hands, both roboses and laparoscopic surgery offer patients through their symptoms,” she said.

While research shows similar complication rates and perioperative results between platforms, robot surgery can offer improved visualization and improved ergonomics for the treatment of endometriosis with deep infiltrating. “Laparoscopic operation is cheaper. In the correct hands it may be a better option,” she said.

In more complex cases, a multidisciplinary approach is required – such as those that affect the kidney, the ureter or the intestine. The platform selection in such cases is shared among the surgical teams involved.

Disclosure:

Mansour does not report any relevant information.

Reference:

Wason M, Mansour T. increased skills and security in identifying and removing endometriosis. Presentation. Presented on: 2025 American College of obstetricians and gynecologists (ACOG) annual clinical and scientific meetings. 16.-18. May 2025. Minneapolis, Minnesota.