Abstract
We are presenting this video to demonstrate the Excision of Deep Infiltrating Rectovaginal Adenomyotic Nodule. Patient is 35 years old, infertile, complaining of severe Dysmenorrhea, Dysparunia and Dyschezia (rectal symptoms). She wanted to be pain free and achieve conception. Her pre-operative Sonography showed diffuse adenomyosis of the uterus and tender nodule at the retro cervical region. She was prepared for laparoscopic management of Rectovaginal Adenomyosis. With cold scissors rectum totally mobilized and dissection continued till rectovaginal septum and nodule totally exposed. Enmasse resection of rectovaginal nodule and vaginal epithelium is done till a healthy margin of vagina achieved on all sides. Resection is done by Harmonic curved blade. Vaginal closure is achieved by laparoscopic suturing. Enmasse Excision of Rectovaginal nodule with vaginal epithelium gives excellent pain relief. Avoidance of rectal resection and end to end anastomosis helps in decreasing the morbidity of the procedure.
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