Robotic single-site excision of ovarian endometrioma
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METHODOLOGY ARTICLE
Open Access
Robotic single-site excision of ovarian endometrioma Antonio R. Gargiulo1,3*, Colleen Feltmate2,3 and Serene S. Srouji1,3
Abstract Background: Conventional single-incision laparoscopic surgery has been successfully employed for treatment of ovarian endometriomas. However, this technique presents surgeons with formidable ergonomic challenges, that make its widespread adoption unlikely. Robotic assistance in single-incision laparoscopic surgery provides adequate instrument triangulation through a single fulcrum, while eliminating ergonomic challenges to the surgeon. The objective of this video is to describe a novel technique of laparoscopic excision and ablation of ovarian endometriomas with single-site robotic assistance. Footage from a single surgical case is shown in our video. The da Vinci Si surgical system with da Vinci Single-Site platform was utilized. A flexible CO2 laser fiber was employed as the main energy tool. To describe a technique of single-incision laparoscopic excision and ablation of endometriomas with robotic assistance. Footage from a single surgical case is shown in this video. The da Vinci Si surgical system with da Vinci Single-Site platform was utilized. A flexible CO2 laser fiber was employed as the main energy tool. Results: Our technique achieved excellent surgical, clinical and cosmetic results, with complete excision and ablation of the endometriomas and no complications. The procedure was completed in day-surgery setting. Conclusion: Our step-by-step video tutorial shows how the dedicated single incision laparoscopy technology for the da Vinci Si surgical system can be safely and effectively applied to the excision and ablation of ovarian endometriomas. Keywords: Endometrioma, Endometriosis, Robotic surgery, Single-incision laparoscopic surgery
Background Endometriomas are peculiar ovarian pseudocysts that lack a true capsule and originate from the invagination and distension of an area of the ovarian cortex. Endometriomas can negatively impact ovarian reserve, cause pain, and can also raise the suspicion of ovarian malignancy. However conservative surgical intervention may be indicated in women of reproductive age. Surgical removal of endometriomas has been associated with significant loss of ovarian follicular reserve and even premature ovarian failure [1]. Therefore, safe and reproducible techniques of endometrioma excision are of paramount clinical importance [2]. Conventional single-incision laparoscopic surgery has been successfully employed for treatment of ovarian endometriomas [3]. Single-incision laparoscopic surgery offers the potential for * Correspondence: [email protected] 1 Division of Reproductive Endocrinology and Infertility, Brigham and Women’s Hospital, Harvard Medical School, 75 Francis St., Boston, MA, USA 3 Center for Robotic Surgery, Brigham and Women’s Hospital, Harvard Medical School, 75 Francis St., Boston, MA, USA Full list of author information is available at the end of the article
improved surgical cosmesis, decr
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