1533 Robotic-Assisted Laparoscopic Excision of Deep Infiltrating Endometriosis Involving the Ureter
This video demonstrates a safe and effective minimally invasive technique for enterolysis, oophorectomy and subsequent ureterolysis in the face of deep infiltrating (DIE) and deep fibrotic endometriosis.
The objectives of our study were to (i) examine the rate of vesico-ureteral injury at benign hysterectomy by surgical approach and (ii) compare the risk of vesico-ureteral injury specifically between minimally-invasive laparoscopic and abdominal hysterectomy on a populational level.DesignRetrospective population-based observational study.SettingThe National Inpatient Sample.Patients501,110 women who underwent hysterectomy for benign gynecological disease from 1/2012-9/2015 were included: total abdominal hysterectomy (TAH, n=284,365 [56.7%]), total laparoscopic hysterectomy (TLH, n=60,410, [12.1%]), abdominal supracerv...
ConclusionThis video shows how deep urinary endometriosis can be performed laparoscopically. Mastering suturing is essential to avoid complications.
To present a successful remission of hydronephrosis, with laparoscopic surgery of complete excision for DIE lesion, and end-to-end anastomosis of left ureter.
To demonstrate methods to compensate for large ureteral defects after extensive resection of ureteral endometriosis. I will present 3 methods, the psoas hitch, the Boari flap and ileal interposition.
To report the results of laparoscopic surgical treatment in patients treated for Deep Infiltrating Endometriosis (DIE) with Urinary Tract involvement (bladder and ureter) and to provide an accurate decision-making algorithm, reporting a large case-series and follow-up data.
ConclusionThe hypogastric nerve follows a predictable course and can be identified, dissected, and spared during pelvic surgery, making it an important landmark for the preservation of pelvic autonomic innervation.
ConclusionAs showed in this case, the laparoscopic nerve-sparing complete excision of endometriosis it's a feasible and reproducible technique in expert hands and, as reported in literature, offers good results in terms of bladder morbidity reduction with apparently higher satisfaction than classical technique.
AbstractBackgroundBladder endometriosis (BE) is the most common external site of deep-infiltrating endometriosis (DIE) affecting the urinary tract. Frequently associated with other DIE lesions, it can be strongly related to a ventral spread of adenomyosis. Possible symptoms are urinary frequency, tenesmus and hematuria, and they are frequently related to DIE of the posterior and lateral compartment. Hormonal therapy can be used in non-symptomatic patients; conversely, in other cases surgical treatment is the management of choice.MethodsRetrospective cohort study of a series of consecutive patients treated between September...
ConclusionsThe variables of rAFS stage IV, USL DIE lesion ≥ 3 cm in diameter and previous surgery for endometriosis significantly increased the risk of UE. Laparoscopic ureterolysis and ureteroneocystostomy are feasible and safe procedures with low complication and recurrence rates.
ConclusionIn bladder endometriosis a combined approach with the urologist can assist in safely excising deep bladder endometriosis without removal of normal bladder tissue. Stents placed in the ureter assist in avoiding injury to the ureters. Demarcating the endometriotic nodule by the urologist through the bladder and excising the bladder nodule laparoscopically is both safe and effective.