8883 Total Laparoscopic Bladder Resection in the Management of Deep Endometriosis: “Take It or Leave It.”

Study Objective To highlight laparoscopic surgical anatomy for bladder resection in deep endometriosis (DE). Design Video article. Setting Laparoscopic 4K OR in IRCCS Sacro Cuore Don Calabria Hospital, Trendelenburg position under general anesthesia. Patients or Participants 35 years old woman complaining chronic pelvic pain and urinary specific symptoms, looking for pregnancy for 4 years. Interventions Opening and development of paravescical spaces, Bogros and Retzius spaces, bladder nodule isolation and resection of the whole-thickness portion of the nodule. En-bloc posterior eradication of DE after opening and development of para-rectal space and recto-vaginal space. Measurements and Main Results Duration of the surgical procedure was 180 minutes, blood loss 50cc, inpatient stay 12 days, Foley catheter was removed after 7 days (cystography was performed to assess bladder closure). Conclusion Laparoscopic bladder resection might be less invasive and precise if anatomical spaces are properly prepared and the resection is limited to the infiltrating portion of the nodule. To highlight laparoscopic surgical anatomy for bladder resection in deep endometriosis (DE). Video article. Laparoscopic 4K OR in IRCCS Sacro Cuore Don Calabria Hospital, Trendelenburg position under general anesthesia. 35 years old woman complaining chronic pelvic pain and urinary specific symptoms, looking for pregnancy for 4 years. Opening and development of paravescical spaces, Bogros and Retzius spaces, bladder nodule isolation and resection of the whole-thickness portion of the nodule. En-bloc posterior eradication of DE after opening and development of para-rectal space and recto-vaginal space. Duration of the surgical procedure was 180 minutes, blood loss 50cc, inpatient stay 12 days, Foley catheter was removed after 7 days (cystography was performed to assess bladder closure). Laparoscopic bladder resection might be less invasive and precise if anatomical spaces are properly prepared and the resection is limited to the infiltrating portion of the nodule.