Endometriosis is still an underestimated cause of a variety of abdominal complaints and the reason for infertility. It is important to bear it in mind, as a diagnosis can currently still take up to 10 years. Therefore, the indications for laparoscopy should be generously assessed. The longer the time has passed until the diagnosis, the poorer the quality of life for the patient. The more advanced the disease, the more radical and extensive are the conservative, surgical and postoperative treatments. Surgical treatment of deep infiltrating endometriosis is a major challenge for surgeons with an interdisciplinary perspective similar to that of pelvic floor surgery in order to achieve uncomplicated pain relief and improvement of fertility. A detailed prediagnosis and careful surgical planning, preferably by the surgeon, is just as essential as standardized follow-up care and complementary treatment options. Radical and en bloc resections are important for long-term prevention of recurrence and relief from complaints. It should be noted that complications, especially anastomosis insufficiencies, must be avoided in order to prevent additional threats to fertility. In each phase of treatment all conservative methods of alternative treatment are discussed with the patient as well as the risks and side effects of surgical and conservative treatment methods.
