Discoid Resection of Rectosigmoid Endometriosis with Laparoscopic Ultrasound Assistance скачать в хорошем качестве

Discoid Resection of Rectosigmoid Endometriosis with Laparoscopic Ultrasound Assistance

This video demonstrates the use of a laparoscopic ultrasound probe to guide discoid resection of a deep rectosigmoid endometriotic lesion, providing real-time imaging for precise and conservative excision. Presented By Dr. Nicole Delaloye Dr. Brittany Macgregor Dr. Jack Chui Dr. Caroline Lee Affiliations University of British Columbia Timestamps (00:08) Disclosures (00:12) Objectives (00:29) Background (00:48) Current Techniques (01:44) Laparoscopic Ultrasound (02:28) Case Presentation (03:09 - 06:43) Procedure Video (06:51) Take-away Points The video outlines a laparoscopic procedure for managing deep rectosigmoid endometriosis with the assistance of an ultrasound probe. The goal is to demonstrate effective surgical techniques for locating and excising endometriotic lesions in challenging cases. In this case, the patient, with stage IV endometriosis and prior surgical history, presented with a recurring 2.5 cm lesion in the rectosigmoid colon. Due to previous surgeries, traditional tactile feedback and visual inspection were insufficient for accurate lesion identification, necessitating the use of laparoscopic ultrasound. The laparoscopic ultrasound probe allowed the surgical team to locate the lesion precisely within the muscularis layer of the rectosigmoid, facilitating a clear view of the lesion's depth and boundaries. With guidance from the ultrasound, a joint decision was made with general surgery to perform a discoid resection, a conservative technique ideal for lesions that do not extend deeply into surrounding tissues. Using a circular transanal stapler, the team successfully resected the targeted area without requiring a full bowel resection, reducing risks and preserving more healthy tissue. Following resection, post-operative tests, including a bubble test and sigmoidoscopy, confirmed complete lesion removal with no anastomotic leaks. The ultrasound confirmed the success of the procedure, ensuring all endometriotic tissue was excised while maintaining bowel integrity. The video emphasizes the value of laparoscopic ultrasound in providing real-time feedback and facilitating conservative, precise excisions in complex cases of deep infiltrative endometriosis. This approach highlights laparoscopic ultrasound as a promising tool in managing difficult-to-detect endometriotic lesions, particularly in patients with surgical histories or complex anatomical presentations, aiding surgeons in selecting optimal, less invasive treatment options.