Laparoscopic surgical treatment of diaphragmatic endometriosis: a 7-year single-institution retrospective review

Marcello Ceccaroni, Roviglione G, Giovanni Roviglione, Pierluigi Giampaolino, Giampaolino P, Roberto Clarizia, Clarizia R, Bruni F, Francesco Bruni, Giacomo Ruffo, Ruffo G, Patrelli TS, Tito Silvio Patrelli, Giuseppe De Placido, Minelli L, Luca Minelli
Surgical endoscopy · 2012 · vol. 27(2) , pp. 625–632 · doi:10.1007/s00464-012-2505-z · PMID:22955897 · W1986278026
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⚙ AI-generated summary by gemini-2.5-flash-lite+body, 2026-06-23 ⓘ

This retrospective study identified 46 cases of diaphragmatic endometriosis among 3,008 patients, with most lesions on the right side, and successfully treated symptomatic patients with complete excision or diathermocoagulation.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-23 · read from full text ⓘ

This 7-year single-institution retrospective review studied consecutive patients with diaphragmatic endometriosis treated with laparoscopy, identifying cases among 3,008 patients undergoing management for pelvic endometriosis and reporting operative findings and treatments. Intraoperatively, 46 patients had diaphragmatic endometriosis, most with multiple right-sided lesions (32 with multiple lesions; 40 right-sided), while a minority had bilateral implants or a single left-sided lesion; most symptomatic patients underwent complete excision of diaphragmatic nodules, with only three cases of superficial right-sided disease treated by diathermocoagulation. The authors emphasize diaphragmatic endometriosis as part of “complete eradication,” but the paper’s main limitation is its retrospective, single-institution design without detailed comparative outcomes or long-term follow-up in the provided text. This paper is centrally about endometriosis — specifically laparoscopic diagnosis and surgical eradication of diaphragmatic endometriosis.

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Abstract

BackgroundDiaphragmatic endometriosis is a rare condition that may cause invalidating epigastric or thoracic pain and catamenial pneumothorax. During the past decades, laparoscopy has been proposed as an optimal tool for diagnosis and surgical eradication of the disease.MethodsWe present a retrospective series of consecutive patients affected by diaphragmatic endometriosis, treated by laparoscopy at our institution, during a period of 7 years.ResultsAmong 3,008 patients with pelvic endometriosis, 46 cases with intraoperative diagnosis of diaphragmatic endometriosis were identified. Operative findings showed multiple diaphragmatic lesions in 32 (69.5 %) patients and single lesions in 14 (30.4 %). Diaphragmatic implants were distributed on the right side in 40 (86.9 %) patients; in 5 patients (10.8 %) they were bilateral and 1 patient had a single lesion on the left hemidiaphragm. Most of the symptomatic patients were treated by complete excision of the nodules, whereas only three patients referring right upper-quadrant abdominal pain and right shoulder catamenial pain had superficial diaphragmatic endometriosis and were treated by diathermocoagulation.ConclusionDiaphragmatic endometriosis should be included in the concept of complete eradication of endometriosis. This kind of surgery has been shown to be feasible and cost-effective; however, it should be managed in a referral center, by an expert laparoscopic gynecologist with knowledge of oncological surgical techniques, with the support of a general surgeon and a trained anesthesiologist.
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Abstract

Background Diaphragmatic endometriosis is a rare condition that may cause invalidating epigastric or thoracic pain and catamenial pneumothorax. During the past decades, laparoscopy has been proposed as an optimal tool for diagnosis and surgical eradication of the disease.

Methods

We present a retrospective series of consecutive patients affected by diaphragmatic endometriosis, treated by laparoscopy at our institution, during a period of 7 years.

Results

Among 3,008 patients with pelvic endometriosis, 46 cases with intraoperative diagnosis of diaphragmatic endometriosis were identified. Operative findings showed multiple diaphragmatic lesions in 32 (69.5 %) patients and single lesions in 14 (30.4 %). Diaphragmatic implants were distributed on the right side in 40 (86.9 %) patients; in 5 patients (10.8 %) they were bilateral and 1 patient had a single lesion on the left hemidiaphragm. Most of the symptomatic patients were treated by complete excision of the nodules, whereas only three patients referring right upper-quadrant abdominal pain and right shoulder catamenial pain had superficial diaphragmatic endometriosis and were treated by diathermocoagulation.

Conclusion

Diaphragmatic endometriosis should be included in the concept of complete eradication of endometriosis. This kind of surgery has been shown to be feasible and cost-effective; however, it should be managed in a referral center, by an expert laparoscopic gynecologist with knowledge of oncological surgical techniques, with the support of a general surgeon and a trained anesthesiologist. Similar content being viewed by others

References

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Condition tags

endometriosisthoracic_endometriosis

MeSH descriptors

Diaphragm Endometriosis Laparoscopy Muscular Diseases Adult Diaphragm Endometriosis Female Humans Muscular Diseases Retrospective Studies Time Factors Young Adult

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