Robotic techniques in endometriosis: six steps for excision of rectovaginal nodules - the butterfly method.

Fertil Steril

Franco-European Multidisciplinary Endometriosis Institute (IFEMEndo), Clinique Tivoli-Ducos, Bordeaux, France; Franco-European Multidisciplinary Endometriosis Institute (IFEMEndo)-Middle East Clinic, Burjeel Medical City, Abu Dhabi, United Arab Emirates; Department of Gynecology and Obstetrics, Aarhus University Hospital, Aarhus, Denmark.

Published: December 2024

Objective: To present a standardized and reproducible approach for the surgical excision of deep endometriosis in the rectovaginal septum, represented by #ENZIAN A.

Design: Surgical video article.

Setting: A tertiary referral center.

Patient(s): The case of a patient with an isolated endometriotic nodule in the rectovaginal septum was used to illustrate the surgical technique, also referred to as the butterfly method.

Intervention(s): An Intuitive Xi DaVinci system was used at the tertiary referral center, IFEMEndo in Bordeaux, France. Patient consent was obtained.

Main Outcome Measure(s): Step-by-step approach for the excision of endometriosis in the rectovaginal septum.

Result(s): This educational film presents a systematic approach dividing the surgical procedure into following six steps: We used the metaphor of the butterfly because it comprehensively and pictorially reflects the resection line of the endometriotic nodule in the rectovaginal septum.

Conclusion(s): Surgical management of rectovaginal endometriosis can be challenging and requires as much as possible the preservation of autonomic nerves. A systematic approach enables the endoscopists to perform a safe and complete removal of the lesion.

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Source
http://dx.doi.org/10.1016/j.fertnstert.2024.09.022DOI Listing

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