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Robotic techniques in endometriosis: six steps for excision of rectovaginal nodules - the butterfly method
Nicolas Samartzis1, Dimitrios Rafail Kalaitzopoulos1, Laurin Burla1
1Department of Gynecology and Obstetrics, Cantonal Hospital of Schaffhausen, Schaffhausen, Switzerland.
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.
