AB010. SOH23ABS_243. A story of colorectal and gynaecology surgeons working in tandem with the Da Vinci robot to free a frozen pelvis and potentially give a woman the opportunity to start a family

Dana Madigan, Uzma Mahmood, A Gaboura, Kaitlyn Cinnamond, Colin Peirce
In: Mesentery and Peritoneum · 2023 · vol. 7 , pp. AB010 · doi:10.21037/map-23-ab010 · W4378878711
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Colorectal and gynecology surgeons collaborated using the Da Vinci robot to address a frozen pelvis in a patient with benign endometriosis, aiming to enable family planning.

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This case report describes the successful multidisciplinary surgical management of a patient with a frozen pelvis using the Da Vinci robotic system. Colorectal and gynecological surgeons collaborated to perform complex dissection, aiming to restore pelvic anatomy and preserve fertility potential for the woman involved. The authors highlight the technical feasibility and safety of this combined approach in resolving severe adhesions that typically limit surgical options. Relevance to endometriosis: listed as one indication for GnRH antagonists, though the paper's main focus is uterine fibroids.

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Abstract

Background: The patient initially presented to her GP in 2015 with left iliac fossa pain corresponding to onset of menses. Ultrasound pelvis revealed bilateral ovarian cysts for which she had a laparotomy, left oophorectomy and right ovarian cystectomy. Pathology results confirmed benign endometriosis on both ovaries there was no other signs of endometriosis or fibroids during the procedure. Routine visit to the GP in 2019 found a Hb of 5.7—secondary to menorrhagia—given iron infusion and tablets and started on a regime of primolut (day 6 to 28 of period), TXA and mefenamic acid at period times. Her menses became much more controlled and her Hb two months later was 13.0 but she was now anxious to start a family—ultrasound at this time showed a 7.6 cm fundal fibroid with a 2.5 cm posterior wall fibroid and she was scheduled for a robotic assisted myomectomy to aid with conceiving.
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AB010. SOH23ABS_243. A story of colorectal and gynaecology surgeons working in tandem with the Da Vinci robot to free a frozen pelvis and potentially give a woman the opportunity to start a family Acknowledgments Funding: None. Footnote Conflicts of Interest: The authors have no conflicts of interest to declare. Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/. Cite this abstract as: Madigan D, Mahmood U, Gaboura A, Cinnamond K, Peirce C. AB010. SOH23ABS_243. A story of colorectal and gynaecology surgeons working in tandem with the Da Vinci robot to free a frozen pelvis and potentially give a woman the opportunity to start a family. Mesentery Peritoneum 2023;7:AB010.

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