Laparoscopic Hysterectomy - Endometriosis
Symptoms
A 32 year old woman presented with a long history of excruciating pelvic pain which significantly impacted her ability to work and function normally. She experienced almost constant pain which included pain during intercourse and pain when passing a bowel motion.
Diagnosis
A detailed ultrasound suggested significant endometriosis involving bowel adhesions. She subsequently underwent laparoscopy which revealed Grade IV endometriosis. Both ovaries were adherent to the pelvic side walls and there were significant right-sided adhesions involving small and large bowel.
Procedure
The bowel adhesions were carefully divided and ovaries mobilised. All visible endometriosis was excised. A Mirena was inserted post-operatively.
Outcome
She made an excellent recovery and reported that she is now pain free and has control of her life again.
Laparoscopic view showing significant bowel adhesions.
All visible endometriosis is excised.
The bowel adhesions are divided and normal right ovary is mobilised. The right ureter is dissected out.
The pelvis at the completion of the procedure. A pelvic drain is removed the following day. Ongoing healing will occur and the inflammatory changes will resolve.