Authors: P. Bartoš 1; M. Vraný 2 Authors‘ workplace: Oddělení gynekologie a minimálně invazivní chirurgie, Nemocnice Na Homolce, Praha, přednostaMUDr. P. Bartoš, FCOG M. MED. 2 Chirurgické oddělení, Nemocnice Jablonec nad Nisou, přednosta MUDr. M. Vraný 1 Published in: Ceska Gynekol 2000; (1): 13-15 Category:
Objective: Laparoscopic excision of deep endometriosis of rectovaginal septum and evaluation oftechnical capabilities of Diomed laser.Design: Prospective pilot study.Setting: Department of Gynaecology and Minimally Invasive Surgery, Na Homolce Hospital, Pra-gueMethods: Eight patients with clinically and laparoscopically diagnosed endometriosis of the recto-vaginal septum were selected for laparoscopic surgery. The extent of the lesion was assessed byvaginal palpations and laparoscopic visualisation of the Douglas space with a sponge forcepsinserted into the posterior vaginal fornix and using rectal probe simultaneously. To excluderectal wall infiltration baryum radiography was performed.Results: 7 out of 8 patients experienced a complete disappearence of symptoms such as dyspareu-nia, dysmenorrhea and pelvic pain. Follow - up is in the range of 1 - 12 months.Summary: Deep infiltrating rectovaginal endometriosis is a specific disease very different fromperitoneal or ovarian endometriosis. A more precise term is rectovaginal adenomyosis. Radical laparoscopic excision is needed. Although simple this is demanding pelvic surgery, the results aregratifying. The use of a laser seems superior to dissection technique.
Key words: laparoscopy, endometriosis, rectovaginal septum, laser
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