Design: Retrospective cohort study

Setting: Community health system

Patients or Participants: Patients who underwent a minimally invasive surgery for known or suspected endometriosis by a high-volume fellowship trained surgeon within Main Line Health System (MLHS) between November 2022 and December 2023.

Interventions: All patients underwent a robotic surgery for endometriosis and immediately after were assigned an endometriosis score based on the 2021 AAGL endometriosis scoring system.

Measurements and Main Results: We identified 151 patients for this analysis. Of these patients 16 (10.6%) had stage 0 or 1 endometriosis, 29 (19.2%) had stage 2, 30 (19.9%) had stage 3, and 76 (50.3%) had stage 4. Overall, postoperative complication rates were low for the study group. There were no statistically significant differences between groups with respect to postoperative readmissions (p=0.38), reoperations (p=0.12), and emergency room visits (p=0.58). There were no documented episodes of DVT or PE, delayed thermal injuries, postoperative hematomas, or blood transfusions for the entire study group. No statistically significant differences were seen with respect to postoperative urinary retention, small bowel obstruction or ileus, or superficial or deep space infections. Rates of concomitant hysterectomy, estimated blood loss, organ injury, and same day discharge did not significantly differ between groups.

Conclusion: We did not find a clinically meaningful association between postoperative complication rates and endometriosis stage based on the newly developed AAGL endometriosis scoring system. Overall, we found a very low rate of both postoperative and intraoperative complications possibly due to the small sample size of this study. Future research should continue to focus on the clinical implications and utility of this newly developed staging system for endometriosis.