ABC of Endometriosis Surgery: Aqua Blue Contrast Technique

Tamer Seckin, Bahar Yüksel, Serin Seckin, A. Ayhan
In: medRxiv · 2020 · doi:10.1101/2020.02.27.20027888 · W3010394823
preprint OA: green CC0 ⤵ 1 in-corpus citation
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⚙ AI-generated summary by claude@2026-06, 2026-06-10 ⓘ

The Aqua Blue Contrast Technique, which enhances surgical vision, was associated with significantly lower endometriosis recurrence rates compared to conventional surgery.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-10 ⓘ

This retrospective study assessed whether the Aqua Blue Contrast Technique (ABCT), which uses methylene blue contrast during laparoscopy with retroperitoneal hydrodistension, improves visualization and reduces recurrence in women undergoing surgery for peritoneal endometriosis. Patients operated from 2014 to 2015 were followed for up to 5 years and compared across three retrospective groups: conventional white-light surgery, ABCT applied to pelvic side walls but not the cul-de-sac, and ABCT applied to the entire peritoneal cavity; ovarian endometriomas and deep infiltrative endometriosis were excluded. Recurrence was lowest in the full-cavity ABCT group (3-year recurrence 3.2%, 5-year recurrence 4.3%), compared with higher rates in the conventional group (11.9% and 16.1%) and the side-wall-only group (8.7% and 12.1%). The paper is limited by its retrospective design and by excluding other endometriosis phenotypes, and it also does not provide methodological details in the excerpt. This paper is centrally about endometriosis — it evaluates a methylene-blue contrast technique (ABCT) intended to detect occult peritoneal lesions and quantify recurrence after endometriosis surgery.

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Abstract

Abstract Objective Peritoneal endometriosis is the most prevalent yet least diagnosed type due to its unrecognizable nature on imaging modalities especially non- pigmented lesions would escape the surgeons’ eye and experience during diagnostic laparoscopy. We used color adjuvant by the technique called Aqua Blue Contrast Technique (ABCT) to optimize the view and to improve results. Material methods Patient charts who undergone surgery from 2014 to 2015 and their 5 year follow up data, along with two different control groups, have been analyzed retrospectively. As the first group the patients who had conventional surgery without the use of ABCT) were included, the second group were patients who had ABCT applied on both pelvic side walls but not in cul-de-sac and as the third group the patients who had the surgery with the use of ABCT in all peritoneal cavity have been analyzed. Cases involving ovarian endometriomas and DIE were excluded. Results All patients have been followed up for up to 5 years. In group 1, the recurrence within the postoperative 3 years was 11.9%, and 16.1% after 5 years of surgery. The recurrence of 3 years period and 5 years period for the patients in group 2 were 8.7& and 12.1% respectively. The patients in group 3 recurred 3.2% in the 3 years period and the 4.3% recurrence rate calculated as 4.5% for the following 5 years after surgery. Conclusion Results indicate elimination of high-end spectrum of light using aqua blue contrast technique with hydrodistension of the retroperitoneum enhances the surgeon’s vision, allows lesions otherwise not detected with white light.

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endometriosisdie_deep_infiltrating

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