Academic OB/GYN

This is an edited video of a robotic hysterectomy and salpingoopherectomy in a patient with stage IV endometriosis, with bilateral endometrioma, cul de sac obliteration, and severe retroperitoneal fibrosis. The video demonstrates ureterolysis, dissection of ovarian vessels from the ureter, and management of colpotomy in the setting of dense adhesions.

Addendum in 2016 – This is a great surgical anatomy video, and shows how to get into the right spaces to complete a hysterectomy laparoscopically in stage IV endometriosis.  That said, it also shows a surgeon failing to resect everything they can.  With ovaries removed a patient like this will do very well, but it would have been possible to remove more disease as well, which may have improved long term symptoms.

Dr. Fogelson is a gynecologic surgeon and endometriosis specialist who practices at Northwest Endometriosis and Pelvic Surgery in Portland, OR.  Call 503-715-1377 for clinical consultation or email nfogelson@nwendometriosis.com. http://www.nwendometriosis.com