Journal article
Diaphragmatic Endometriosis: Multidisciplinary Treatment.
- Seidler S Departments of Obstetrics and Gynecology (Drs. Seidler, Shabanov, Wenger, and Pluchino) and.
- Shabanov S Departments of Obstetrics and Gynecology (Drs. Seidler, Shabanov, Wenger, and Pluchino) and.
- Andres A Surgery (Drs. Andres and Karenovics), University Hospital of Geneva, Geneva, Switzerland.
- Karenovics W Surgery (Drs. Andres and Karenovics), University Hospital of Geneva, Geneva, Switzerland.
- Wenger JM Departments of Obstetrics and Gynecology (Drs. Seidler, Shabanov, Wenger, and Pluchino) and.
- Pluchino N Departments of Obstetrics and Gynecology (Drs. Seidler, Shabanov, Wenger, and Pluchino) and. Electronic address: nicola.pluchino@hcuge.ch.
- 2018-07-22
Published in:
- Journal of minimally invasive gynecology. - 2019
CO(2) laser surgery
Diaphragmatic endometriosis
Multidisciplinary treatment
Adult
Combined Modality Therapy
Diaphragm
Dyspareunia
Endometriosis
Female
Humans
Laparoscopy
Laser Therapy
Lasers, Gas
Muscular Diseases
Pelvic Floor Disorders
Pelvic Pain
English
STUDY OBJECTIVE
To demonstrate a safe laparoscopic procedure for diaphragmatic infiltrative endometriosis.
DESIGN
Video case SETTING: Teaching hospital (Canadian Task Force classification III).
PATIENTS
One patient presenting deep and severe diaphragmatic endometriosis.
INTERVENTION
Laparoscopic cure of diaphragmatic endometriosis.
MEASUREMENTS AND MAIN RESULTS
Throughout this video, which was approved by the institutional board review, we demonstrate safe and complete surgical treatment of a patient suffering severe pelvic and diaphragmatic endometriosis. The patient complained of menstrual dyspnea and shoulder pain persisting despite hormonal treatment, associated with persistent dyspareunia and pelvic pain despite a previous laparoscopic surgery. Patient positioning and anesthesia were adapted to the special requirements of the surgical technique and the expected risks. The operation consisted of the exposure of the right diaphragm by mobilization of the liver, CO2 laser vaporization of left and right diaphragmatic lesions, nerve-sparing excision of infiltrating nodules, and pleural exploration. Finally, we performed an excision of pelvic endometriosis. Participation of 3 surgical teams to this procedure allowed a safe and complete laparoscopic treatment with resolution of pain symptoms at a 1- and 3-month follow-up.
CONCLUSION
Laparoscopic treatment allows a safe and complete treatment of diaphragmatic endometriosis.
To demonstrate a safe laparoscopic procedure for diaphragmatic infiltrative endometriosis.
DESIGN
Video case SETTING: Teaching hospital (Canadian Task Force classification III).
PATIENTS
One patient presenting deep and severe diaphragmatic endometriosis.
INTERVENTION
Laparoscopic cure of diaphragmatic endometriosis.
MEASUREMENTS AND MAIN RESULTS
Throughout this video, which was approved by the institutional board review, we demonstrate safe and complete surgical treatment of a patient suffering severe pelvic and diaphragmatic endometriosis. The patient complained of menstrual dyspnea and shoulder pain persisting despite hormonal treatment, associated with persistent dyspareunia and pelvic pain despite a previous laparoscopic surgery. Patient positioning and anesthesia were adapted to the special requirements of the surgical technique and the expected risks. The operation consisted of the exposure of the right diaphragm by mobilization of the liver, CO2 laser vaporization of left and right diaphragmatic lesions, nerve-sparing excision of infiltrating nodules, and pleural exploration. Finally, we performed an excision of pelvic endometriosis. Participation of 3 surgical teams to this procedure allowed a safe and complete laparoscopic treatment with resolution of pain symptoms at a 1- and 3-month follow-up.
CONCLUSION
Laparoscopic treatment allows a safe and complete treatment of diaphragmatic endometriosis.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1016/j.jmig.2018.07.003
- PMID 30031207
- Persistent URL
- https://sonar.ch/global/documents/169568
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