Laparoscopic Excision of Pericardial and Diaphragmatic Endometriosis
This video presents a five-step approach to the laparoscopic excision of pericardial and diaphragmatic endometriosis. Clinically, endometriosis affects the thoracic cavity in less than 1% of cases, most commonly involving the diaphragm and treated using a VATS approach.
Pericardial endometriosis is an even rarer entity, with only 4 case reports published to date. We present the case of a 35-year-old in order to illustrate the approach to a laparoscopic excision of diaphragmatic and pericardial endometriosis. In consultation with the
Thoracic team, she is consented for a completion surgery of thoracic endometriosis identified at a prior laparoscopy, symptomatic for right shoulder and mid-chest pain, and unresponsive to medical therapy. The surgical approach consists of 5 reproducible steps:
1. Upper abdominal survey
2. Liver mobilization
3. Excision of diaphragmatic and pericardial lesions