What are the benefits and risks of having an open presacral neurectomy done for stage 3-4 endometriosis with 4 previous laps. Removing endo&adh.?

Pain reduction. A pre-sacral neurectomy will not cure your endometriosis. However, by cutting some of the sensory nerves to the pelvis, it will decrease the amount of pain you expirience, particularly during your menstrual period.
Complicated. Excellent question but impossible to answer properly in a short-answer format! basically comes to morbidity/mixed success of psn vs. Quality of life and multiple laps procedures. If you or someone you know is considering presacral neurectomy, face-to-face consult with an expert surgeon is the only way to decide. A second-opinion consult may also be helpful in this case.