What are peritoneal pockets in endometriosis?

Peritoneal pockets are small indentations or fold-like defects in the peritoneum, the thin lining that covers the pelvic organs and inner abdominal wall. During endometriosis surgery, we may see these pockets as tucked-in areas or little pits in the peritoneal surface. They can be associated with superficial peritoneal endometriosis or early or developing disease patterns.

These pockets matter because endometriosis doesn’t always look like obvious black or red implants. It can hide within subtle anatomic changes, scarring, or altered peritoneal contours. In the operating room, careful inspection and technique are important so that disease within or around a peritoneal pocket isn’t missed or treated only on the surface. If you’ve been told you have “peritoneal pockets,” our team can help you understand what that finding may mean in your case, based on your symptoms, imaging, and whether deeper structures (like bowel, bladder, or ureters) could also be involved.