Application of AAGL Endometriosis Classification - An Innovative Tool with Additional Contributions

Abstract

<h3>Study Objective</h3> To demonstrate application of the innovative newly developed AAGL 2021 endometriosis anatomy-based surgical complexity scoring system and add further contributions. <h3>Design</h3> An overall step-by-step application of the new surgical scoring system developed in 2021 with emphasis on pragmatic utilization of the App through two case reports. <h3>Setting</h3> A university hospital based on Detroit, Michigan; Wayne State University/ Detroit Medical Center <h3>Patients or Participants</h3> A series of two case reports of stage 4 endometriosis based on the Scoring System, including one with endometriosis on the diaphragm. Each patient case demonstrates variety of symptoms and challenges - including pelvic pain and abdominal pain. <h3>Interventions</h3> Application and utilization of the AAGL 2021 Endometriosis Classification. <h3>Measurements and Main Results</h3> Successful identification of intra-operative endometriosis with staging on the AAGL 2021 Endometriosis Classification Scoring System. <h3>Conclusion</h3> Application of AAGL 2021 Endometriosis Classification remains to be very effective in surgical complexity scoring. The classification offers an alternative point system in quantifying endometriotic lesions. This point system allows for a way to numerically scale the disease from a surgical complexity standpoint. Due to its intraoperative utility, the AAGL Endometriosis Classification correlates to pain and avoids limitations that noninvasive imaging may experience and focuses predominantly on pain symptoms. Additional contributions may include addition of extra-pelvic endometriosis, such as the diaphragm. The overall goal is to improve care of endometriosis patients, from addressing chronic pelvic pain, abdominal pain, and fertility complications, with an objective intraoperative staging system.