Diagnostic laparoscopy endometriosis treatment

• positioned in lithotomy position
• It is recommended to position both arms alongside the body (caution: use cotton wrapping when positioning with a cloth sling), or position one arm on the assistant's side
• The legs should be adjustable in angle via the operating table controls
• if necessary, use shoulder supports to prevent the patient from slipping on the operating table
• if necessary, attach a cervical adapter

Creation of a pneumoperitoneum by inserting a Veress needle, usually infraumbilical. Insertion with the optical trocar infraumbilical.

A thorough assessment of the entire abdominal cavity is essential, as endometriosis lesions can occur not only in the pelvis but also in other regions. The inspection is performed systematically:

Upper abdomen (subphrenic regions, liver, diaphragm, omentum)

• Typical findings:
  • Endometriosis lesions on the diaphragm (often small, brown, or blue lesions).
  • Adhesions between the liver, diaphragm, and stomach.
  • Fibrin deposits or adhesions in the area of the right diaphragm.

Mid-abdomen (small intestine, ascending/descending colon, appendix, greater omentum)

• Typical findings:
  • Endometriotic lesions on the small intestine or colon (usually in the area of the cecum or sigmoid).
  • Involvement of the greater omentum with fibrotic adhesions.
  • Endometriotic changes on the appendix.