Video Presentation AGES XXVIII Annual Scientific Meeting 2018

Laparoscopic discoid resection of rectal deeply infiltrative endometriosis nodule - Retroperitoneal anatomy of pararectal and retrorectal spaces in nerve-sparing endometriosis surgery (5599)

Sarah Choi 1 , Dean Conrad 1 , Matthew Morgan 1 , Stefaan Pacquee 1 , Lionel Reftmann 1 , Gregory M. Cario 1 , Danny Chou 1 , David Rosen 1
  1. Sydney Women’s Endosurgery Centre, Sydney, NSW

This video presentation showed the surgical footages of laparoscopic complete excision of endometriosis and discoid rectal nodule resection in a 31-year-old nulliparous lady presented with severe dysmenorrhoea (pain score 9/10), deep dyspareunia (7/10) and dyschezia (6/10) refractory to medical treatment. Pre-operative deep endometriosis ultrasound scan showed a 2+cm endometriosis rectal nodule involving muscularis. A discoid nodule excision with circular stapler was eventually carried out as minimally invasive approach.

The surgical steps of nerve-sparing endometriosis excision technique (1) are demonstrated. The presentation also focuses on the surgical anatomy of retroperitoneal spaces, ureter, vascular system and sympathetic pelvic nerves applicable to rectal resection for deeply infiltrative endometriosis. The laparoscopic anatomy is compared to traditional topographic anatomy with surgical footages and anatomical illustrations.

  1. 1. Nerve-sparing laparoscopic eradication of deep endometriosis with segmental rectal and parametrial resection: the Negrar method. A single-center, prospective, clinical trial. Ceccaroni M1, Clarizia R, Bruni F, D'Urso E, Gagliardi ML, Roviglione G, Minelli L, Ruffo G. Surg Endosc. 2012 Jul;26(7):2029-45.
  • Have you presented oral, video or DCS at an AGES meeting before?: Yes
  • Are you a trainee and if so at what level?: Not a trainee
  • Are you a subspecialists or AGES member?: Yes