Ovarian cystectomy involves manually separating the cyst wall from ovarian tissue(14). As explained above, there is no cleavage plane (separation) between the two, but cystectomy also removes fibrotic tissue part surrounding the endometriotic cyst.

The major drawback of this technique is that the ovarian reserve may be irreversibly affected. Indeed, the absence of a plane of cleavage causes more persistent bleeding in the ovarian cortex, thereby obliging the surgeon to use bipolar coagulation, which in turn impacts ovarian vascularization(14).

Moreover, previous studies have demonstrated that 60-75% of endometriotic ovarian cystectomy specimens contained oocytes upon histological analysis(14). Nevertheless, this surgical technique is associated with a lower risk of recurrence. The CEC therefore advocates this approach when patients have no wish for pregnancy. If they want to conceive, are infertile or wish to maintain their fertility, other available operative techniques are offered by the CEC.