Laparoscopic shaving of rectosigmoid deep infiltrating endometriosis under laparoscopic ultrasound guidance

OBJECTIVE: To present laparoscopic shaving of rectosigmoid endometriosis using the novel approach of laparoscopic ultrasound guidance to enhance complete excision. DESIGN: Video article. SETTING: Academic Tertiary Hospital. PATIENT(S): A 41-year-old G3P2012 female with longstanding history of pelvic pain refractory to medical management. Imaging was suggestive of deep infiltrating endometriosis involving the rectosigmoid colon. INTERVENTION(S): Laparoscopy for rectosigmoid endometriosis with the use of intraoperative ultrasound. MAIN OUTCOME MEASURE(S): Laparoscopic excision of rectosigmoid endometriosis under ultrasound guidance. RESULT(S): N/A. CONCLUSION(S): It is important to perform a complete pre-operative evaluation to determine the extent of disease and the necessity of a multidisciplinary approach. Intraoperative laparoscopic ultrasound can provide additional information including size and depth of lesions, which could play a role in surgical decision making. Laparoscopic ultrasound may enhance complete excision of deep endometriosis lesions and decrease the incidence of recurrence.