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Case Reports
. 2010 Feb 10:8:Doc03.
doi: 10.3205/000092.

Total laparoscopic hysterectomy with obliterated anterior cul-de-sac

M Sami Walid  1 , Richard L Heaton
Affiliations
Case Reports

Total laparoscopic hysterectomy with obliterated anterior cul-de-sac

M Sami Walid et al. Ger Med Sci. .

Abstract
in English, German

Endometriosis may in severe cases lead to obliteration of the anterior and/or posterior cul-de-sacs in the female pelvis. The anterior cul-de-sac is generally less commonly affected. This type of cases usually presents a challenge for the operating surgeon, whether via open route or through laparoscopy. In this paper, we present an illustrative case and explain our technique for dealing with a scarred and totally obliterated anterior cul-de-sac because of endometriosis during total laparoscopic hysterectomy.

Endometriose kann bei schwerem Verlauf den vorderen und hinteren Douglassack im weiblichen Becken verschließen. Der vordere Douglassack (Excavatio vesicouterina) ist im Allgemeinen weniger betroffen. Diese Art des Verlaufs ist in der Regel eine Herausforderung für den gynäkologischen Operateur, sei es über direkten Zugang oder durch Laparoskopie. Diese Publikation beschreibt einen typischen Fall von vernarbtem und obliteriertem vorderen Douglassack auf der Basis einer Endometriose und erklärt die Operationstechnik unter Einsatz einer totalen laparoskopischen Hysterektomie.

Keywords: adhesions; anterior cul-de-sac; endometriosis; scarring.

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Figures

Figure 1
Figure 1. Obliterated anterior cul-de-sac
Figure 2
Figure 2. Uterus removed
See this image and copyright information in PMC

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