The ovarian endometrioma: why is it so poorly managed? Laparoscopic treatment of large ovarian endometrioma: why such a long learning curve?

The laparoscopic management of ovarian endometrioma was reported more than 15 years ago. An anonymous survey conducted among gynaecologists in the UK showed that 50% of ovarian endometrioma are still managed by laparotomy. This surprising result is discussed emphasizing the difficulties of the learning curve, pitfalls in surgical training and mistakes of the pioneers. Endoscopic surgery will become the standard technique when all practising gynaecologic surgeons have been trained during their residency. The goal of the endoscopic surgeon should be to achieve adequate surgical treatment. Endoscopic surgery is not a technical gimmick used to avoid laparotomy and to attract patients.