Laparoscopic excision of liver endometriosis

In: Geburtshilfe und Frauenheilkunde · 2024 · vol. 84(10) , pp. e231 · doi:10.1055/s-0044-1790993 · W4403328345
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This paper details a laparoscopic excision for a rare case of liver endometriosis causing right shoulder and upper abdominal pain, demonstrating the procedure and its effectiveness.

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This paper presents a case-based surgical video on laparoscopic excision of exceptionally rare hepatic endometriosis in a woman with recurrent right upper abdominal and right shoulder pain despite a history of endometriosis. MRI showed a nodular perihepatic mass with hemosiderin deposition, and the authors describe using a 0-degree laparoscope to perform adhesiolysis, expose the lesion, and resect deep-infiltrating endometriosis in the upper abdomen. The paper concludes that laparoscopic excision appears suitable and effective for hepatic endometriosis but emphasizes that such procedures are uncommon and should be performed by an experienced surgical team, with the major caveat being the limited evidence base implied by a single/few-case context. This paper is centrally about endometriosis — specifically hepatic endometriosis managed via laparoscopic excision.

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Introduction

Hepatic endometriosis is an exceptionally rare condition, with only a handful of cases reported to date. Currently, there are no established guidelines for the surgical management of hepatic endometriosis.

Keywords

Liver endometriosis, laparoscopic excision, right shoulder pain

Methods

A laparoscopic approach was recommended for a woman with a history of endometriosis experiencing recurrent pain in the right upper abdomen and right shoulder. Magnetic Resonance Imaging (MRI) revealed a nodular perihepatic mass with hemosiderin deposition. Considering persistent pain and compromised quality of life, a surgical intervention to excise the endometriosis was planned. A 0-degree laparoscope was employed to remove deep-infiltrating endometriosis in the upper abdomen.

Results

This video outlines the procedure in the following steps: - Presentation of the upper abdomen's anatomical structures. - Adhesiolysis of the liver and liberation of liver attachments. - Detailed exposure of the liver endometriosis. - Resection of the liver endometriosis.

Conclusion

Laparoscopic excision emerges as a suitable and effective method for addressing hepatic endometriosis. Nonetheless, it remains an uncommon procedure and should only be undertaken by a skilled surgical team with experience managing such cases. Video upload: https://player.vimeo.com/video/940031997 Publication History Article published online: 01 October 2024 © 2024. Thieme. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany

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Condition tags

endometriosis

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