Thinking Outside the Peritoneal Cavity: A Novel Approach to a Rare Disease

Abstract

Study Objective The objective of this video is to describe a novel surgical approach to hepatic endometriosis invading the retroperitoneum. Design Video case presentation. Setting Tertiary care academic medical center. Patients or Participants 61 year old woman with aggressive recurrent endometriosis who presents with new right upper quadrant pain and a MRI showing a sub-hepatic mass consistent with an endometriosis lesion. Interventions Laparoscopic excision of the endometriosis nodule using a posterior retroperitoneal approach. Measurements and Main Results N/A Conclusion Hepatic endometriosis is a very rare form of extrapelvic endometriosis. Sub-hepatic lesions, including those invading through Morrison's pouch, can be safely accessed via the posterior retroperitoneal approach during laparoscopy. When faced with a complicated patient and unusual pathology, it is crucial to be creative, consider all surgical approaches and seek help outside your surgical expertise.