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| Name | Surgical Management of Diaphragmatic Endometriosis |
| Video Uploader | Video From CanSAGE Secretariat |
| Upload Date | This Video Uploaded At 08-09-2022 14:22:30 |
| Video Discription | The video demonstrates the surgical management of diaphragmatic endometriosis using a laparoscopic approach, highlighting the importance of a multidisciplinary team for successful peri-operative care and step-wise excision. It presents a case of a 34-year-old woman who experienced complete resolution of her symptoms after surgery. Read the full transcript here: https://cansagevideos.com/surgical-management-of-diaphragmatic-endometriosis/ Presented By Dr. Cici Zhu Dr. Michael Suen Dr. Sebastien Gilbert Dr. Margaret Ann Fraser Dr. Sukhbir Sony Singh Affiliations University of Ottawa, The Ottawa Hospital Timestamps (00:08) Diaphragmatic Endometriosis (00:35) Surgical Options (00:44) Video-assisted Thorascopic Surgery (01:13) Surgical Case (01:34) Radiology (01:47) Thoracic Consultation (01:59) Anesthesia (02:13) Operative Set-Up (02:28) Falciform Ligament Video (02:35) Liver Retractor Video (02:46) Endometriotic Deposits Video (02:56) Peritoneum and Striated Muscle Video (03:57) Pleural Cavity and Lung Video This educational video from The Ottawa Hospital's Minimally Invasive Group showcases the surgical management of diaphragmatic endometriosis, a rare condition that often presents as catamenial pneumothorax, hemothorax, or shoulder tip pain. The video emphasizes the importance of a multidisciplinary team approach, including minimally invasive gynecological surgeons, thoracic surgeons, radiologists, and anesthesiologists, to optimize peri-operative management and surgical outcomes. The video outlines two surgical options for resecting diaphragmatic endometriosis: the thoracic approach via video-assisted thoracoscopic surgery (VATS) and the laparoscopic approach. VATS is typically performed by thoracic or general surgeons, allowing comprehensive exploration of the thorax and resection of tissue for histological confirmation. The laparoscopic approach, which requires coordination among multiple specialties, is demonstrated in this case. The case presented involves a 34-year-old woman with a 12-year history of debilitating catamenial right shoulder pain and dysmenorrhea. Previous laparoscopic ablation of diaphragmatic lesions had been unsuccessful, and medical treatments were not tolerated due to side effects. Imaging revealed a sub-diaphragmatic endometriotic deposit, and the patient consented to surgical excision. The surgical procedure began with the resection of the falciform ligament to visualize the diaphragm. A liver retractor was then used to expose the right dome of the diaphragm, revealing additional endometriotic deposits. The video details the careful resection of the largest lesion, which involved both the central tendon of the diaphragm and adjacent diaphragmatic muscle. During the procedure, the pleural cavity was entered, and the lung was inspected for additional endometriotic deposits, though none were found. The diaphragmatic defect left by the resection was closed with multiple layers of sutures, including interrupted horizontal mattress non-absorbable sutures followed by a running barbed suture. A chest tube was placed and removed on the first post-operative day without respiratory complications. |
| Category | People & Blogs |
| Tags | diaphragmatic endometriosis | Ottawa Hospital | endometriosis | excision | step-wise surgical approach | peri-operative management | laparoscopic approach | thoracic approach |
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