Endometriosis, a common gynecological condition, is more common in women of childbearing age. The incidence has been increasing year by year in recent years. Endometriosis can be broadly divided into two types, one is intrinsic endometriosis and the other is extrinsic endometriosis. Intrinsic endometriosis is the so-called adenomyosis, also known as adenomyosis. It is called intrinsic endometriosis because in this case the endometrium is not detached from the uterus and is still inside the uterus, but instead of overlying the uterine cavity like a normal endometrium, it grows in the uterine muscle. Adenomyosis is also subdivided into general adenomyosis and adenomyoma according to the density and morphology of the lesions. In the case of general adenomyosis, the lesions are routinely and diffusely distributed, while in the case of adenomyoma, the lesions are more concentrated and form a mass. In fact, they are essentially the same disease, and there is no major difference in clinical presentation and management. I will not go into the pathology and symptoms of endometriosis as I have introduced them more often, but here I will focus on the case of ectopic lesions to other parts of the body. The so-called extrinsic endometriosis refers to the growth of the normal endometrium to sites outside the uterus, and the relevant sites are very extensive, including the fallopian tubes, cervix, vulva, appendix, umbilicus, abdominal wall incision, hernia sac, bladder, lymph nodes, and even the pleura and pericardium, upper limbs, thighs, etc. It can be said that the focal tissue may be ectopic to every part of the body. Special endometriosis – “DIE”, also known as deep infiltrative endometriosis, refers to the invasion of the endometrium into the deep peritoneum and pelvic organs, and the depth of invading tissue exceeds 5 mm, which is called “DIE Some patients ask, “In such a complicated case, is it necessary to remove the uterus to solve the problem? Patients who ask this question actually do not understand “DIE” endometriosis, which is an ectopic disease outside the uterus, so even if the uterus is removed, it will not solve the problem. Can this type of endometriosis be treated together with a uterine-preserving U+ operation? The answer is: Yes, U+ surgery is a surgical procedure to remove adenomyosis, adenomyoma, multiple fibroids, and ectopic lesions in the entire pelvis. We have encountered many such cases in the U+ procedure. Some time ago, we also met a patient from Shanghai who not only had coeliac disease, but also an ectopic lesion between the vagina and the rectum, DIE! Because this condition often involves the pelvic floor muscles, blood vessels, nerves, and organs such as the intestines and ureters, it can be very troublesome to manage. This patient had undergone emergency surgery a few years ago for sudden rupture and hemorrhage of the coeliac sac, and the lesions were found to be extensive and very difficult to operate on. It took a lot of effort for everyone, but finally the operation was successful and the patient’s problem was solved.