Endometriosis pp 105-115 | Cite as

Treatment of Endometriosis of the Cul-de-Sac

  • David B. Redwine


The cul-de-sac holds special importance in endometriosis treatment. It is the pelvic area most commonly involved by the disease (Table 12.1). Indeed, although Sampson’s original publications in the 1920s made it appear that the ovary was the most commonly involved pelvic site, two decades later he realized that peritoneal disease was more common and clinically more important.1-3 Gynecologic surgeons, therefore, must become proficient in identifying and treating cul-de-sac endometriosis.


Bowel Wall Active Electrode Uterosacral Ligament Rectovaginal Septum Rectosigmoid Colon 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Arch Surg 1921;3:245–323.Google Scholar
  2. 2.
    Sampson JA. Ovarian hematomas of endometrial type (perforating hemorrhagic cysts of the ovary) and implantation adenomas of the endometrial type. Bost Med Surg J 1922;186:445–456.CrossRefGoogle Scholar
  3. 3.
    Sampson JA. The development of the implantation theory for the origin of peritoneal endometriosis. Am J Obstet Gynecol 1940;40:549–557.Google Scholar
  4. 4.
    Jenkins S, Olive DL, Haney AF. Endometriosis: pathogenic implications of the anatomic distribution. Obstet Gynecol 1991;67:335–338.Google Scholar
  5. 5.
    Redwine DB. Mulleriosis: the single best fit model of origin of endometriosis. J Reprod Med 1988;33:915–20.Google Scholar
  6. 6.
    Fujii S. Secondary mullerian system and endometriosis. Am J Obstet Gynecol 1991;165:219–25.PubMedGoogle Scholar
  7. 7.
    Redwine DB. The distribution of endometriosis in the pelvis by age groups and fertility. Fertil Steril 1987;47: 173–175.PubMedGoogle Scholar
  8. 8.
    Sharpe DR, Redwine DB. Laparoscopic segmental resection of the sigmoid and rectosigmoid colon for endometriosis. Surgical Laparoscopy Endoscopy 1992;2:120–14.PubMedGoogle Scholar
  9. 9.
    Ripps BA, Martin DC. Focal pelvic tenderness, pelvic pain and dysmenorrhea in endometriosis. J Reprod Med 1991;36:470–472.PubMedGoogle Scholar
  10. 10.
    Redwine DB. Laparoscopic en bloc resection for treatment of the obliterated cul-de-sac in endometriosis. J Reprod Med 1992;37:695–698.PubMedGoogle Scholar
  11. 11.
    Koninckx PR, Martin DC. Deep endometriosis: a consequence of infiltration or retraction or possibly adeno-myosis externa? Fertil Steril 1992;58:924–928.PubMedGoogle Scholar
  12. 12.
    Evers JLH. The second-look laparoscopy for evaluation of the result of medical treatment of endometriosis should not be performed during ovarian suppression. Fertil Steril 1987;47:502–504.PubMedGoogle Scholar
  13. 13.
    Murphy AA, Green WR, Bobbie D, et al. Unsuspected endometriosis documented by scanning electron microscopy in visually normal peritoneum. Fertil Steril 1986; 46:522–54.PubMedGoogle Scholar
  14. 14.
    Jansen RPS, Russell P. Nonpigmented endometriosis. Clinical, laparoscopic, and pathologic definition. Am J Obstet Gynecol 1986;155:1154–1159.PubMedGoogle Scholar
  15. 15.
    Redwine DB. Is “microscopic” peritoneal endometriosis invisible? Fertil Steril 1988;50:665–666.PubMedGoogle Scholar
  16. 16.
    Nisolle M, Paindaveine B, Bourdon A, et al. Histologic study of peritoneal endometriosis in infertile women. Fertil Steril 1990;53:984–988.PubMedGoogle Scholar
  17. 17.
    Redwine DB, Yocom L. A serial section study of visually normal peritoneum in patients with endometriosis. Fertil Steril 1990;54:648–651.PubMedGoogle Scholar
  18. 18.
    Nezhat F, Allan CJ, Nezhat C, et al. Nonvisualized endometriosis at laparoscopy. Int J Fertil 1991;36:340–33.PubMedGoogle Scholar
  19. 19.
    Redwine DB. Treatment of endometriosis-associated pain. In Olive DL, ed. Endometriosis: Infertility and Reproductive Medicine Clinics of North America. Philadelphia, WB Saunders, 1992, pp 697–720.Google Scholar
  20. 20.
    The American Fertility Society. Revised American Fertility Classification system of endometriosis: 1985. Fertil Steril 1985;44:351–352.Google Scholar
  21. 21.
    Redwine DB. Conservative laparoscopic excision of endometriosis by sharp dissection: life table analysis of reoperation and persistent or recurrent disease. Fertil Steril 1991;56:628–634.PubMedGoogle Scholar
  22. 22.
    Wheeler JM, Malinak LR. Recurrent endometriosis. Contr Gynecol Obstet 1987;16:13–21.Google Scholar
  23. 23.
    Redwine DB. Nafarelin vs Danazol vs Surgery. Fertil Steril 1992;58:455–456.PubMedGoogle Scholar
  24. 24.
    Griffin L, Noller K, Kaminetzky H, et al. Personal communications, 1991.Google Scholar
  25. 25.
    Cook AS, Rock JA. The role of laparoscopy in the treatment of endometriosis. Fertil Steril 1991;55:663–680.PubMedGoogle Scholar
  26. 26.
    Sulewski JM, Curcio FD, Bronitsky C, et al. The treatment of endometriosis at laparoscopy for infertility. Am J Obstet Gynecol 1980;138:128–132.PubMedGoogle Scholar
  27. 27.
    Seiler JC, Gidwani G, Ballard L. Laparoscopic cauterization of endometriosis for fertility: a controlled study. Fertil Steril 1986;46:1098–1100.PubMedGoogle Scholar
  28. 28.
    Hasson HM. Electrocoagulation of pelvic endometriotic lesions with laparoscopic control. Am J Obstet Gynecol 1979;135:115–119.PubMedGoogle Scholar
  29. 29.
    Murphy AA, Schlaff WD, Hassiakos D, et al. Laparoscopic cautery in the treatment of endometriosis-related infertility. Fertil Steril 1991;55:245–251.Google Scholar
  30. 30.
    Pitkin R. Operative lapaoscopy: Surgical advance or technical gimmick. Obstet Gynecol 1992;79:441–442.PubMedCrossRefGoogle Scholar
  31. 31.
    Redwine DB, Sharpe DR. Laparoscopic segmental resection of the sigmoid colon. Journal of Laparoendoscopic Surgery 1991;1:217–220.PubMedCrossRefGoogle Scholar
  32. 32.
    Nezhat F, Nezhat C, Pennington E. Laparoscopic proctectomy for infiltrating endometriosis of the rectum. Fertil Steril 1992;57:1129–1132.PubMedGoogle Scholar
  33. 33.
    Summitt RL Jr, Stovall TG, Lipscomb GH, Ling FW. Randomized comparison of laparoscopy-assisted vaginal hysterectomy with standard vaginal hysterectomy in an outpatient setting. Obstet Gynecol 1992;80:895–901.PubMedGoogle Scholar
  34. 34.
    Widdowson EM, Dicerkson JWT. Composition of the body. In Diem K, Lentner C, eds. Geigy Scientific Tables, 7th ed. Basle, 1970, pp 517–522.Google Scholar
  35. 35.
    Reich H, McGlynn G, Salvat J. Laparoscopic treatment of cul-de-sac obliteration secondary to retrocervical deep fibrotic endometriosis. J Reprod Med 1991;36:516–522.PubMedGoogle Scholar
  36. 36.
    Nezhat C, Nezhat F, Pennington E. Laparoscopic treatment of infiltrative rectosigmoid colon and rectovaginal septum endometriosis by the technique of videolaser laparoscopy and the CO2 laser. Brit J Obstet Gynecol 1992;99:664–667.CrossRefGoogle Scholar
  37. 37.
    Gold BS, Kitz DS, Lecky JH, et al. Unanticipated admission to the hospital following ambulatory surgery. JAMA 1989;262:3008–3010.PubMedCrossRefGoogle Scholar
  38. 38.
    Koninckx PR, Meuleman C, Demeyere S, Lesaffre E, Cornillie FJ. Suggestive evidence that pelvic endometriosis is a progressive disease, whereas deeply infiltrating endometriosis is associated with pain. Fertil Steril 1991;55: 759–765.PubMedGoogle Scholar

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© Springer-Verlag New York, Inc. 1995

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  • David B. Redwine

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