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João ALVES

Hospital Divino Espirito Santo
Ponta Delgada, Portugal
MD
1732 likes
55874 views
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Laparoscopic treatment of a deep endometriotic nodule in the ischiatic tuberosity
In this challenging surgery performed by Professor Arnaud Wattiez, we present the case of a 39-year-old woman suffering from deep infiltrating endometriosis and infertility with no previous surgeries. The patient presented with chronic pelvic pain, dyschezia, and dyspareunia. Preoperative workup included MRI and rectosigmoidoscopy. MRI revealed a nodule at the level of the right uterosacral ligament. Rectosigmoidoscopy revealed a bulging of the anterior rectal wall located at 6cm from the anal verge where biopsy revealed fibrosis. The patient’s physical examination demonstrated the presence of a retrouterine nodule at the site of the right uterosacral ligament measuring 3cm.
A Wattiez, R Fernandes, M Puga, J Alves, C Redondo Guisasola
Surgical intervention
4 years ago
1986 views
35 likes
0 comments
03:00
Laparoscopic treatment of a deep endometriotic nodule in the ischiatic tuberosity
In this challenging surgery performed by Professor Arnaud Wattiez, we present the case of a 39-year-old woman suffering from deep infiltrating endometriosis and infertility with no previous surgeries. The patient presented with chronic pelvic pain, dyschezia, and dyspareunia. Preoperative workup included MRI and rectosigmoidoscopy. MRI revealed a nodule at the level of the right uterosacral ligament. Rectosigmoidoscopy revealed a bulging of the anterior rectal wall located at 6cm from the anal verge where biopsy revealed fibrosis. The patient’s physical examination demonstrated the presence of a retrouterine nodule at the site of the right uterosacral ligament measuring 3cm.
Laparoscopic oophorectomy for solid ovarian mass
We present the case of a 28-year-old woman with no relevant previous surgical or medical history. The patient was addressed for the removal of a right ovarian mass. She presented with dysmenorrhea and occasional dyspareunia. There were no other symptoms. Her physical examination showed a right adnexal mass to the vaginal touch. Preoperative work-up included a pelvic ultrasound, which showed a tumor apparently originating from the right ovary, of solid homogeneous appearance. MRI confirmed the presence of the solid mass, measuring approximately 6cm. No other pathological findings were present in the rest of the abdominal cavity. Tumor markers were negative. The patient had not completed childbearing and desired a conservative surgical approach. The different aspects of the surgical management were explained, including the possibility of performing an oophorectomy if no healthy ovarian tissue could be identified.
A Wattiez, C Redondo Guisasola, M Puga, R Fernandes, J Alves
Surgical intervention
5 years ago
4899 views
79 likes
0 comments
08:33
Laparoscopic oophorectomy for solid ovarian mass
We present the case of a 28-year-old woman with no relevant previous surgical or medical history. The patient was addressed for the removal of a right ovarian mass. She presented with dysmenorrhea and occasional dyspareunia. There were no other symptoms. Her physical examination showed a right adnexal mass to the vaginal touch. Preoperative work-up included a pelvic ultrasound, which showed a tumor apparently originating from the right ovary, of solid homogeneous appearance. MRI confirmed the presence of the solid mass, measuring approximately 6cm. No other pathological findings were present in the rest of the abdominal cavity. Tumor markers were negative. The patient had not completed childbearing and desired a conservative surgical approach. The different aspects of the surgical management were explained, including the possibility of performing an oophorectomy if no healthy ovarian tissue could be identified.
Laparoscopic segmental resection in a patient with deep infiltrating endometriosis
We present the case of a 33-year-old-woman suffering from deep infiltrating endometriosis. In her previous history, three laparoscopies had been performed due to endometriosis. In the first two laparoscopies, bilateral ovarian cystectomies had been carried out while the third laparoscopy had been indicated to puncture the ovaries after hormonal stimulation for in vitro fertilization (IVF), due to the impossibility of reaching follicles transvaginally.
The patient presented with dysmenorrhea, dyspareunia and dyschezia, as well as rectorrhagia and diarrhea. The patient’s physical examination demonstrated the presence of a retrouterine mass suggestive of adhesions. Preoperative work-up included MRI and colonoscopy. MRI showed an endometriotic nodule affecting the rectosigmoid junction and infiltrating its wall. A colonoscopy was performed and allowed to visualize the endometriotic nodule.
A Wattiez, C Redondo Guisasola, M Puga, J Alves, R Fernandes
Surgical intervention
5 years ago
2558 views
30 likes
0 comments
18:50
Laparoscopic segmental resection in a patient with deep infiltrating endometriosis
We present the case of a 33-year-old-woman suffering from deep infiltrating endometriosis. In her previous history, three laparoscopies had been performed due to endometriosis. In the first two laparoscopies, bilateral ovarian cystectomies had been carried out while the third laparoscopy had been indicated to puncture the ovaries after hormonal stimulation for in vitro fertilization (IVF), due to the impossibility of reaching follicles transvaginally.
The patient presented with dysmenorrhea, dyspareunia and dyschezia, as well as rectorrhagia and diarrhea. The patient’s physical examination demonstrated the presence of a retrouterine mass suggestive of adhesions. Preoperative work-up included MRI and colonoscopy. MRI showed an endometriotic nodule affecting the rectosigmoid junction and infiltrating its wall. A colonoscopy was performed and allowed to visualize the endometriotic nodule.