7446 Teaching the Teacher: Performance of a Laparoscopic Complete Peritonectomy

Abstract

<h3>Study Objective</h3> To present our surgical technique for performing and teaching a complete peritonectomy. <h3>Design</h3> A stepwise demonstration of our complete peritonectomy technique with narrated video footage. <h3>Setting</h3> As the complete peritonectomy procedure for endometriosis is becoming more generally accepted we aim to review key principles and techniques to safely perform and teach a laparoscopic peritonectomy. Several laparoscopic robotic assisted videos exist describing the surgical technique for performing a peritonectomy, we demonstrate a laparoscopic approach which differs from performing it robotically. <h3>Patients or Participants</h3> A 25-year-old-female with chronic pelvic pain and abnormal uterine bleeding who presented for a surgical consultation for the management of suspected endometriosis as the source of her chronic pelvic pain. <h3>Interventions</h3> A diagnostic laparoscopy was advised for the definitive exclusion or inclusion of endometriosis. The key principles for performing and teaching a laparoscopic complete peritonectomy include: - Detailed anatomic knowledge - Proper identification and dissection of the ureter - Providing traction - Electrocautery to maintain hemostasis - Structured dissection of the peritoneum <h3>Measurements and Main Results</h3> Pathology confirmed endometriosis as the etiology of her pain and the patient recovered well without any postoperative complications. <h3>Conclusion</h3> A laparoscopic complete peritonectomy can be used to assist with the diagnosis and management of pelvic pain. It can be safely performed and taught with adequate knowledge of anatomy and basic surgical principles.