Laser Assisted Appendectomy

Abstract

<h3>Study Objective</h3> Appendiceal endometriosis is commonly encountered by gynecologists during laparoscopy for endometriosis or chronic pelvic pain. This video reviews appendiceal endometriosis, highlights important anatomical landmarks for appendectomy and demonstrates a novel technique for laparoscopic appendectomy using a CO2 Laser at the time of surgical management of endometriosis. <h3>Design</h3> This video uses still images, video footage and narration to review appendiceal endometriosis and laser-assisted appendectomy. The laser appendectomy approach is reviewed in four steps, addressing preoperative and intraoperative considerations. <h3>Setting</h3> Patient positioned in Trendelenburg position with left lateral tilt. <h3>Patients or Participants</h3> Patients undergoing gynecologic laser laparoscopic surgery for endometriosis or chronic pelvic pain. <h3>Interventions</h3> Laser assisted laparoscopic appendectomy. <h3>Measurements and Main Results</h3> When performing a laparoscopy for endometriosis or chronic pelvic pain assess the appendix for signs of endometriosis. The four key steps when planning a laser appendectomy are (1) patient preparation, (2) isolate the appendix, (3) secure blood supply, and (4) remove appendix. <h3>Conclusion</h3> Appendiceal endometriosis is common and pre-operative diagnosis is challenging. Appendectomy should be considered at the time of gynecologic surgery for endometriosis or chronic pelvic pain. This video can be used as a reference for gynecologists when performing appendectomy at the time of hysterectomy or laparoscopy for endometriosis or chronic pelvic pain.