Fig. 1: Potential biological mechanisms of endometriosis recurrence.
From: Rethinking endometriosis recurrence: from clinical challenge to biological opportunity
The left panel illustrates surgery-related mechanisms contributing to lesion recurrence, including minimal residual disease (resulting from incomplete excision, invisible peritoneal lesions, or impaired immune clearance of remaining endometriotic cells as a result of surgical transient immunosuppression) as well as the unintentional dissemination of viable endometrial material with the capacity to implant in the peritoneal cavity and give rise to recurrent lesions. The right panel depicts potential mechanisms of de novo lesion formation, integrating several hypotheses described in the literature. Surgical scars are also represented as favorable implantation sites for disseminated endometriotic cells or menstrual debris, potentially facilitating lesion establishment. Created in BioRender. Delgado, R. (2026) https://BioRender.com/1s91uhu.
