Safe step by step technique to unfreezing the frozen pelvis and safely completing a laparoscopic hysterectomy for a patient with deep infiltrating endometriosis
This video presents a Total Laparoscopic Hysterectomy (TLH) for severe Deep Infiltrating Endometriosis (DIE) with extensive pelvic adhesions and distorted anatomy. The surgery emphasizes meticulous retroperitoneal dissection and repeated identification of both ureters before proceeding with disease excision. Viewers will learn techniques for developing the pararectal and rectovaginal spaces, safely separating the rectum from the posterior cervix and vagina, and managing complex endometriotic fibrosis. Throughout the procedure, the surgeon explains important anatomical landmarks, surgical strategies, and practical tips for preventing ureteric and bowel injuries. This is an excellent educational video for surgeons looking to improve their skills in advanced laparoscopic endometriosis surgery.