Advanced operative laparoscopy in general, and videolaseroscopy using CO2 laser via operative channel of the laparoscope and video, specifically, has revolutionized the management of endometriosis. Adhesion formation is reduced and subsequent fertility rates exceed those obtained with laparotomy. The most complicated cases of endometriosis, including involvement of the rectovaginal septum, gastrointestine, and urinary tract, can now be treated endoscopically by an experienced operative laparoscopist.