An effective “water injection”-assisted method for excision of ovarian endometrioma by laparoscopy

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Ning-Ning Zhang, M.D., Tian-Shui Sun, M.D., Qing Yang, Ph.D.



To introduce an effective approach for excision of ovarian endometrioma by “water injection”-assisted laparoscopy treatment.


Step-by-step video explanation of the surgical procedure with still pictures and surgical video clips to demonstrate the detailed technique, approved by the Shengjing Hospital of China Medical University.




A 26-year-old young woman diagnosed with a 6 cm in diameter right ovarian cyst, who endured 5 years of dysmenorrhea.


The “water injection”-assisted laparoscopic excision of ovarian endometrioma consists of five steps: rupture the ovarian endometrial cyst and remove the “chocolate fluid;” inject the “water” (diluted vasopressin solution) into the interface between endometrioma and ovarian parenchyma; stop injecting until the solution overflow; separate the endometrioma away from the ovarian parenchyma; and suture the ovary.

Main Outcome Measures

Value and feasibility of “water injection”-assisted laparoscopic excision of ovarian endometrioma.


The “water injection”-assisted laparoscopic excision of ovarian endometrioma was feasible and effective. In the follow-up period, the patient did not report any symptom of dysmenorrhea; and the sex hormone and antimüllerian hormone tests reached to normal levels.


Our surgical approach demonstrated several noteworthy advantages. After “water injection”, the endometrioma and ovarian parenchyma was easily distinguished and separated. The approach avoided normal ovarian tissue destruction during endometrioma separation. The utilization of diluted vasopressin solution might decrease bleeding of ovarian wound. Considering its simplicity of realization, our surgical approach should be promoted to more reproductive-age patients.

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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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