Mr. James Tibbott is a Consultant Gynecologist with Leeds Teaching Hospital, Leeds, UK. His areas of interest are pelvic and extra-pelvic endometriosis and chronic pelvic pain. During this episode, Dr. Tibbott will perform a laparoscopic excision of endometriosis, alongside a bilateral salpingectomy-oophorectomy, and bowel surgery. Dr. Tibbott will answer questions in a live chat format throughout the episode.
PROGRAM:
Clinical Background
Welcome and Introduction
Technique Description
Overview of the session and learning objectives.
Case Presentation
Surgical Procedure – Steps
Diagnostic Laparoscopy Assessment of the extent of disease, adhesions, and organ involvement.
Adhesiolysis Systematic and careful dissection of pelvic adhesions using sharp and energy-based techniques.
Ureterolysis Mobilization of ureters where necessary to prevent injury and ensure anatomical clarity.
Bladder Dissection Separation of the bladder from the uterus and cervix, particularly in fibrotic or infiltrated planes.
Rectovaginal Space Dissection Mobilization of the rectum from the posterior cervix and vagina. Excision of nodules if present.
Ligation of Uterine Vessels Skeletonization and sealing at the uterine isthmus with ureter identification.
Colpotomy Circumferential incision at the vaginal cuff using energy devices.
Specimen Removal Transvaginal extraction or morcellation (if no malignancy suspected), with endobag to prevent spillage.
Vaginal Cuff Closure Performed laparoscopically or transvaginally using delayed absorbable sutures.
Final Inspection Hemostasis check and assessment for possible ureteral or bowel injury.
Closing remarks
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