40 - Partial Vaginectomy for Excision of Rectovaginal Endometriosis

Abstract

Rectovaginal endometriosis, a variant of deep infiltrating endometriosis, can cause dyspareunia and dyschezia when it involves the rectovaginal wall. It most commonly affects the posterior vaginal fornix and nodularity is often palpable in the posterior cul-de-sac on pelvic exam. Oftentimes, surgical excision is necessary to provide symptomatic relief. This video will demonstrate the excision of rectovaginal endometriosis through two examples – A) after completion of a total laparoscopic hysterectomy and B) performed conservatively when the uterus is left in-situ. We demonstrate advanced surgical techniques and tips in laparoscopic retroperitoneal dissection and laparoscopic suturing for reconstruction of the vagina to ensure complete excision in the definitive treatment of this lesion.