Laparoscopic excision of pericardial and diaphragmatic endometriosis

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Authors:

Dong Bach Nguyen, M.D., Sebastien Gilbert, M.D., Kristina Arendas, M.D., M.H.M., Caitlin A. Jago, M.D., M.Sc., Sukhbir S. Singh, M.D. 

Abstract:

Objective

To present a five-step approach to the laparoscopic excision of pericardial and diaphragmatic endometriosis.


Design

Surgical video.


Setting

Academic tertiary care hospital.


Patient(s)

35-year-old nulliparous woman observed for chronic pelvic pain and infertility with a diagnosis of diaphragmatic endometriosis at a prior laparoscopy. Symptoms included severe chest pain and right shoulder tip pain, refractory to multiple medical therapies.


Intervention(s)

Laparoscopic excision of pericardial and diaphragmatic endometriosis.


Main Outcome Measure(s)

Description of the relevant anatomy, the literature surrounding pericardial and diaphragmatic endometriosis, and the approach to the surgical intervention and postoperative care.


Result(s)

The laparoscopic excision of the full-thickness pericardial and diaphragmatic endometriotic lesions was successfully completed according to five reproducible steps: upper abdominal survey, liver mobilization, excision of diaphragmatic endometriosis, intrathoracic laparoscopic exploration, and closure of the diaphragmatic defect.


Conclusion(s)

Although rare and challenging to diagnose and treat, pericardial and diaphragmatic endometriosis and its potentially debilitating symptoms can be successfully managed through a multidisciplinary and stepwise surgical intervention.

Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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