Leili Hafizi
1 
, Najmeh Parsai
2 , Yaser Abolhasani
3 , Simin Zeinadini
4 , Zahra Shahryarpanah
5 , Farkhondeh Sameipoor
6 , Sara Sadat Mirhosseini
7 , Fatemeh Sharifian
7 , Zahra Eydizadeh
8 , Farzane Hasani
1* 1 Obstetrics and Gynecology Department, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
2 School of Paramedical Sciences, Shiraz University of Medical Sciences, Darab, Iran
3 Department of Operating Room Technology, School of Paramedical Sciences, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
4 Student Research Committee, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
5 Operating Room Technology Department, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran
6 Department of Operating Room, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
7 Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
8 Department of Operating Room Nursing, Mother and Child Welfare Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
Abstract
Laparoscopic surgery remains the gold standard for the diagnosis and management of endometriosis, offering both therapeutic and diagnostic advantages in a minimally invasive setting. Recent advances in surgical techniques and perioperative strategies have significantly improved the precision and outcomes of laparoscopic interventions. Recent evidence indicates that these refined techniques are associated with improved clinical outcomes, including sustained pain relief, enhanced fertility rates, and improved quality of life. The role of individualized surgical planning, guided by lesion phenotype and patient-specific factors, has gained increasing importance in optimizing therapeutic success. Additionally, the integration of laparoscopic surgery with adjunctive hormonal therapies and multidisciplinary care models contributes to reducing recurrence rates and improving long-term disease control. Despite these advances, challenges remain, including variability in surgical expertise, heterogeneity in disease presentation, and inconsistencies in outcome reporting across studies. Recurrence and persistent symptoms continue to affect a subset of patients, highlighting the need for standardized protocols and long-term follow-up. Accordingly, complications and recurrence are still important considerations. More extensive disease tends to require longer operations and is associated with higher conversion and complication rates, especially in stage 3–4 endometriosis. Even when surgery is technically successful, endometriosis can recur, and many authors now emphasize combining surgery with postoperative hormonal suppression when appropriate to reduce recurrent symptoms and lesion activity. This state has encouraged a more individualized model in which the surgical plan is balanced against the patient’s pain burden, fertility goals, ovarian reserve, prior operations, and tolerance for recovery time.