A rectovaginal endometriosis (RVE) is the most severe form of endometriosis. The gold standard for diagnosis is laparoscopy with histologic confirmation. A review of the literature suggests that surgery improves up to 70% of symptoms with generally favorable outcomes.
In this video, we provide a general introduction to endometriosis and a discussion of disease treatment options, ranging from hormonal suppression to radical bowel resections. We also illustrate the steps in robot-assisted laparoscopic excision of an RVE nodule:
- identify the borders of the rectosigmoid
- dissect the pararectal spaces
- release the rectosigmoid from its attachment to the RVE nodule
- identify and isolate the ureter(s)
- determine the margins of the nodule
- ensure complete resection.
Excision of an RVE nodule is a technically challenging surgical procedure. Use of the robot for resection is safe and feasible when performed by a trained and experienced surgeon.
I am pleased to bring you this video, and I hope that it is helpful to your practice.
>> Arnold P. Advincula, MD
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