Laparoscopic treatment of symptomatic diaphragmatic endometriosis: A case report
Open accessAbstract
Extreme caution and meticulous surgery are imperative when treating the surface of the diaphragm. This procedure should only be performed by an experienced laparoscopic surgeon after appropriate consultation with a cardiothoracic surgeon. Proper care, a thorough understanding of surrounding anatomic structures, and familiarity with laparoscopic instrumentation including the CO2 laser are required for the safe laser vaporization or excision of any peritoneal surface using hydrodissection (7).
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Among women with endometriosis, 12% are estimated to experience extragenital endometriosis.
“Among this population, 12% are estimated to experience endometriosis of nonreproductive organs, referred to as extragenital endometriosis.2–7”
From Thoracic Endometriosis Syndrome: A Review of Diagnosis and Management (2019) · cites this paper as [6]
Diaphragmatic endometriosis is a rare entity, often asymptomatic, and has been described only in small series.
“Diaphragmatic endometriosis is a rare entity, often asymptomatic, which has been described only in small series.”
Endometriosis is found 9 times more frequently on the right side than on the left.
“In support of this theory is the fact that endometriosis is found 9 times more frequently on the right side than on the left [ 6 , 10 ].”
From Thoracic Endometriosis Syndrome: A Comprehensive Review and Multidisciplinary Approach to Management (2024) · cites this paper as [6]
Pelvic endometriosis is thought to develop 5-7 years prior to symptoms of thoracic endometriosis syndrome.
“Pelvic endometriosis is thought to develop 5–7 years prior to symptoms of TES [ 6 , 10 ].”
From Thoracic Endometriosis Syndrome: A Comprehensive Review and Multidisciplinary Approach to Management (2024) · cites this paper as [6]
Extra abdominopelvic manifestations of endometriosis are more commonly located in the thorax.
“A sizable number of extra abdominopelvic manifestations have been described, more commonly in the thorax [ 6 , 7 , 8 , 9 , 10 ].”
From Thoracic Endometriosis Syndrome: A Comprehensive Review and Multidisciplinary Approach to Management (2024) · cites this paper as [6]
Symptoms of diaphragmatic endometriosis may arise due to phrenic nerve irritation and referred pain to the periscapular region or neck, most often on the right side.
“Symptoms may arise due to phrenic nerve irritation and referred pain to the periscapular region or to the neck, most often on the right side [ 6 ].”
From Thoracic Endometriosis Syndrome: A Comprehensive Review and Multidisciplinary Approach to Management (2024) · cites this paper as [6]
Cites
6 Classification of endometriosis
Canis, M. J., de Jolinières, J. B., Wattiez, A., Pouly, J. L., Mage, G., MANHES, H., & Bruhat, M. A. (1993) · Baillière s Clinical Obstetrics and Gynaecology · doi:10.1016/s0950-3552(05)80462-6 · Cited by 119 · see citing works
Safe laser endoscopic excision or vaporization of peritoneal endometriosis
NEZHAT, C. R., & Nezhat, F. R. (1989) · Fertility and Sterility · doi:10.1016/s0015-0282(16)60805-1 · Cited by 74 · see citing works
Self-citationCatamenial pneumothorax: the roles of diaphragmatic defects and endometriosis
Slasky, B. S., Rd, S., Jw, L., Zajko, A., & Burkholder, J. (1982) · American Journal of Roentgenology · doi:10.2214/ajr.138.4.639 · Cited by 68 · see citing works
Reproductive endocrinology, infertility, and contraception
Mishell, D. R., & Davajan, V. (1979) · Medical Entomology and Zoology · Cited by 59 · see citing works
Operative laparoscopy for the treatment of ovarian remnant syndrome
Nezhat, F. R., & NEZHAT, C. R. (1992) · Fertility and Sterility · doi:10.1016/s0015-0282(16)55016-x · Cited by 50 · see citing works
Self-citationClassification of Endometriosis
Damario, M. A., & Rock, J. A. (1997) · Seminars in Reproductive Medicine · doi:10.1055/s-2008-1068753 · Cited by 21 · see citing works
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Thoracic Endometriosis Syndrome: A Review of Diagnosis and Management
Nezhat, C., Lindheim, S. R., Backhus, L., Vu, M., Vang, N., Nezhat, A., & Nezhat, C. (2019) · JSLS : Journal of the Society of Laparoendoscopic Surgeons · doi:10.4293/jsls.2019.00029 · Cited by 189 · see citing works
Self-citationDiaphragmatic endometriosis: diagnosis, surgical management, and long-term results of treatment
Redwine, D. B. (2002) · Fertility and Sterility · doi:10.1016/s0015-0282(01)02998-3 · Cited by 141 · see citing works
Different types of extragenital endometriosis: A review
Bergqvist, A. (1993) · Gynecological Endocrinology · doi:10.3109/09513599309152504 · Cited by 116 · see citing works
Multidisciplinary Treatment for Thoracic and Abdominopelvic Endometriosis
Nezhat, C., Main, J., Paka, C., Nezhat, A., & Beygui, R. E. (2014) · JSLS : Journal of the Society of Laparoendoscopic Surgeons · doi:10.4293/jsls.2014.00312 · Cited by 108 · see citing works
Self-citationVercellini, P., Abbiati, A., Vigano, P., Somigliana, E. D., Daguati, R., Meroni, F., & Crosignani, P. G. (2007) · Human Reproduction · doi:10.1093/humrep/dem224 · Cited by 91 · see citing works
Laparoscopic surgical management of diaphragmatic endometriosis
Nezhat, C., Seidman, D. S., Nezhat, F., & Nezhat, C. (1998) · Fertility and Sterility · doi:10.1016/s0015-0282(98)00056-9 · Cited by 81 · see citing works
Self-citationCassina, P. C., Weder, W., Hauser, M., Kacl, G., Imthurn, B., & Schröder, S. (1997) · Chest · doi:10.1378/chest.111.5.1447 · Cited by 78 · see citing works
Nezhat, C., Nicoll, L. M., Bhagan, L., Huang, J. Q., Bosev, D., Hajhosseini, B., & Beygui, R. E. (2009) · Journal of Minimally Invasive Gynecology · doi:10.1016/j.jmig.2009.06.012 · Cited by 64 · see citing works
Self-citationThoracic Endometriosis Syndrome: A Comprehensive Review and Multidisciplinary Approach to Management
Nezhat, C., Amirlatifi, N., Najmi, Z., & Tsuei, A. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13247602 · Cited by 36 · see citing works
Self-citationPagano, F., Schwander, A., Vaineau, C., Knabben, L., Nirgianakis, K., Imboden, S., & Mueller, M. D. (2023) · Journal of Minimally Invasive Gynecology · doi:10.1016/j.jmig.2023.01.006 · Cited by 31 · see citing works
Ceccaroni, M., Roviglione, G., Rosenberg, P., Pesci, A., Clarizia, R., Bruni, F., Zardini, C., Ruffo, G., Placci, A., Crippa, S., et al. (2012) · Videosurgery and Other Miniinvasive Techniques · doi:10.5114/wiitm.2011.26758 · Cited by 24 · see citing works
“Diaphragmatic endometriosis has been described in case reports and in small series [8-18]; it can be asymptomatic or pain can be referred to the right or left upper abdominal quadrants, thorax and arms.”
BackgroundDiaphragmatic Endometriosis: Diagnosis and Surgical Management — A Case Report
Wolthuis, A. M., Aelvoet, C., Bosteels, J., & Vanrijkel, J. P. (2003) · Acta Chirurgica Belgica · doi:10.1080/00015458.2003.11679481 · Cited by 12 · see citing works
- Authors
- Nezhat, F., Nezhat, C., & Levy, J. S.
- Affiliations
- Mercer University (US)
- Venue
- Fertility and Sterility
- Publisher
- Elsevier BV
- Published
- 1992-09
- Volume
- 58
- Issue
- 3
- Pages
- 614-616
- ISSN
- 0015-0282 (ISSN-L)
- OpenAlex
- W2395712431
- Cited by
- 34
- References
- 6
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 1 · 2023: 1 · 2021: 2 · 2020: 1 · 2019: 1 · 2018: 2 · 2017: 1 · 2016: 1 · 2014: 1 · 2013: 2 · 2012: 4
- FWCI
- 1.19
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Fertility and Sterility (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Obstetrics and Gynecology › Gynecological conditions and treatments
- Health Sciences › Medicine › Surgery › Minimally Invasive Surgical Techniques
- Keywords
- diaphragmatic endometriosis, laparoscopic surgery, CO2 laser vaporization, hydrodissection, surgical safety
- MeSH terms
- Adult, Diaphragm, Endometriosis, Female, Humans, Laparoscopy, Laser Therapy
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