OP16.07: Same day ultrasound imaging and laparoscopic surgery for the diagnosis of deep infiltrating endometriosis

Women suspected to have significant endometriosis from clinical history and examination or previous diagnostic laparoscopy underwent detailed ultrasound for the presence of DIE. The ultrasound operators were blinded to the clinical findings. The ultrasound findings were relayed to the surgeon and images/AVI saved. The ultrasound operators viewed the subsequent operative procedures. Same day ultrasound and intra-operative findings were compared to assess the accuracy of ultrasound as a diagnostic tool. We present several of these cases demonstrating interesting aspects of DIE. Excellent correlation was seen between the ultrasound and intra-operative surgical findings. Bowel nodules were readily visible at ultrasound. Interestingly there were cases in which the ultrasound scan identified disease that may have been difficult to recognise at surgery such a nodule in the sigmoid, upper rectum or caecum. Pre-consented intra-operative ultrasound enabled visualisation of small nodules in the retrocervical region and on the uterosacral ligaments. DIE can be accurately determined with pelvic ultrasound. The technique for diagnosing DIE is involved and requires education and training. ‘Same day’ pelvic ultrasound has proved a beneficial training tool. It provides immediate feedback for the sonologist, enables audit of accuracy of the technique and increases the enthusiasm of the referring surgeon by convincing them of the utility of ultrasound in the diagnosis of DIE.