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| Name | Evidence-Led Approach to the Surgical Treatment of Endometriosis |
| Video Uploader | Video From CanSAGE Secretariat |
| Upload Date | This Video Uploaded At 29-10-2024 16:00:59 |
| Video Discription | This video outlines an evidence-based approach to treating endometriosis surgically, detailing techniques for addressing both peritoneal and deep endometriosis, with specific procedures like focal excision, peritonectomy, and ablation highlighted for their advantages and limitations. Presented By Dr. Erica Pascoal Dr. Siddhi Mathur Affiliations St. Michael’s Hospital, University of Toronto Timestamps (00:05) Introduction (00:23) ESHRE Classification of Endometriosis (00:40) Approaches to Peritoneal Disease (01:50) Focal Excision of Peritoneal Disease (02:05) Peritonectomy (02:52) Preparing the Pelvis (03:00) Enterolysis (03:19) Ovariolysis (03:55) Ureterolysis (04:18) Deep Endometriosis Involving the Rectovaginal Space (05:32) Conclusions The video provides a comprehensive overview of an evidence-based surgical approach to endometriosis, guided by recommendations from international gynecologic societies. It emphasizes systematic techniques that enable surgeons to operate effectively in cases with distorted pelvic anatomy. Endometriosis manifests in various forms, including peritoneal, deep endometriosis, and ovarian endometriomas, but the video primarily focuses on treating peritoneal and deep endometriosis using methods supported by recent evidence. For peritoneal disease, three key approaches are discussed: focused excision, peritonectomy, and ablation. Each has distinct benefits and drawbacks; for example, focused excision is efficient but may leave microscopic disease behind, while peritonectomy allows for more comprehensive tissue removal but carries higher surgical risks. Ablation is particularly useful for superficial disease, especially in hard-to-reach areas like the diaphragm, though it limits histopathologic diagnosis. The video also details surgical techniques for addressing deep endometriosis, especially when it involves the rectovaginal septum. Procedures include mobilizing organs like the sigmoid colon and ovaries, carefully isolating the ureter, and systematically dissecting adhesions to access affected areas safely. Methods for identifying the ureter, hypogastric nerves, and ensuring bowel integrity are also highlighted, showcasing an organized approach to preserving anatomical structures and function. Ultimately, the video underscores the importance of an evidence-based approach to improve patient outcomes, minimize recurrence, and ensure long-term symptom relief in patients with complex cases of endometriosis. The presented techniques provide a standardized approach to treating both superficial and deep disease, incorporating the latest clinical guidelines. |
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