Endometriosis Video Tool Kit
The following videos from SurgeryU are being highlighted in honor of Endometriosis awareness month.
The first video, published in SurgeryU in 2013, shows the laparoscopic excision of a 3cm vaginal endometrioma by Dr. Ted T.M. Lee and Dr. Nicole Donnellan. The video provides a practical and structured approach to the laparoscopic management of vaginal endometriosis with parametrial infiltration. The authors discuss how to delineate the borders of deeply infiltrating disease and the techniques for ureterolysis and parametrectomy in the presence of extensive fibrosis.
The second video, published in SurgeryU by Dr. Cindy Mosbrucker in 2013, shows a robotic repair of a vesicovaginal fistula that developed as a complication after a bladder injury in the context of an incomplete excision of a deeply infiltrating vaginal endometrioma. The patient failed 3 prior attempts of fistula repair and was ultimately cured only after complete excision of the remaining vaginal endometrioma in addition to fistula repair. Dr. Mosbrucker discusses the use of prophylactic double J stents to prevent ureteral obstruction from perioperative swelling and bladder decompression with continuous drainage to decrease tension on the repair. Interestingly, hyperbaric oxygen and fibrin sealant were also utilized to enhance the therapeutic impact of surgery.
Both trainees and advanced surgeons can take away practical lessons from these videos including the importance of surgical planning, the importance of complete removal of endometriotic disease, the inherent complications these complex surgeries can lead to, and the negative impact incomplete surgery can have on patient outcomes. Though the focus of these videos is not on fertility preservation, both videos feature techniques that would also be applicable in that context.
Click the link to play the video – https://surgeryu.com/public/13cmmosbrucker
Click the link to play the video – https://surgeryu.com/public/13nmdonnellan