INTRODUCTION: This is the case of a 31-year-old G0 with dysmenorrhea, catamenial shoulder pain, infertility, and recently aborted laparoscopic excision of endometriosis secondary to extent of disease. She presented to a MIGS provider at an academic medical center for surgical resection of endometriosis. OBJECTIVE: To review preoperative planning and intraoperative technique for resection of diaphragmatic endometriosis in a patient with dysmenorrhea and hemorrhagic pleural effusion. METHODS: Robotic-assisted laparoscopic excision of pelvic and diaphragmatic endometriosis. RESULTS: This is a case of a patient with a recently aborted laparoscopy at an outside facility who presented for consultation. On imaging, she was found to have a large right-sided hemorrhagic pleural effusion requiring preoperative drainage. She was subsequently taken to the operating room for robotic-assisted laparoscopic excision of pelvic and diaphragmatic endometriosis, which included resection of a full-thickness diaphragmatic lesion and placement of a chest tube. CONCLUSIONS: While rare, diaphragmatic endometriosis can be associated with significant morbidity. Interdisciplinary surgical and anesthetic planning, as well as sound operative technique, allow for successful robotic excision of diaphragmatic lesions.
Parker et al. (Fri,) studied this question.