Laparoscopic removal of deep endometriosis of the vaginal vault following hysterectomy

OBJECTIVE: To describe the laparoscopic management of vaginal vault deep endometriosis following hysterectomy. DESIGN: Video article with case report. SUBJECTS: A 41-year-old woman presenting with vaginal bleeding, severe dyspareunia, and dyschezia after hysterectomy. EXPOSURE: Laparoscopic excision of a deep endometriotic nodule originating from the vaginal vault and extending into the rectovaginal region. MAIN OUTCOME MEASURES: Complete excision of the lesion and resolution of symptoms. RESULTS: The endometriotic nodule was excised successfully laparoscopically. Histopathologic analysis confirmed deep endometriosis. At 6-month follow-up, the patient reported complete resolution of dyspareunia and dyschezia without the need for analgesics. CONCLUSION: Laparoscopic excision is a safe and effective approach for the management of vaginal vault deep endometriosis, particularly in cases with rectovaginal extension, providing excellent symptom relief and improved quality of life.