Two-Step Parametrial Endometriosis Nodule Excision Using Virtual Reality Technology and 3D Modelling for Surgical Planning

Extensive and infiltrative fibrous adhesions of the uterus and ovaries to the surrounding organs make surgical interventions in endometriosis challenging. A preoperative identification of these involvements can help the surgeon better prepare for the surgery. Traditionally, ultrasonography and magne...

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Main Authors: Rooma Sinha, Sukhbir Singh, Teresa Flaxman
Format: Article
Language:English
Published: Wiley 2025-01-01
Series:Case Reports in Obstetrics and Gynecology
Online Access:http://dx.doi.org/10.1155/crog/5513823
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author Rooma Sinha
Sukhbir Singh
Teresa Flaxman
author_facet Rooma Sinha
Sukhbir Singh
Teresa Flaxman
author_sort Rooma Sinha
collection DOAJ
description Extensive and infiltrative fibrous adhesions of the uterus and ovaries to the surrounding organs make surgical interventions in endometriosis challenging. A preoperative identification of these involvements can help the surgeon better prepare for the surgery. Traditionally, ultrasonography and magnetic resonance imaging (MRI) have been used. However, clinical use of modern VR technology for creating and visualising a three-dimensional (3D) digital model for a complex surgical case has been proposed. We describe a case of a 29-year-old who presented with dyspareunia and dysmenorrhea (VAS score of 10/10) with left parametrial endometriosis and created a 3D model from their two-dimensional (2D) DICOM images. A left parametrial endometriosis nodule was identified involving the left ureter, rectum, and vaginal fornix along with mucosa. A virtual preoperative surgery was done for precise and complete excision of the disease and to prevent injury to the left ureter and rectum. The surgery was performed as a two-step excision using a da Vinci Xi robot and included left ureterolysis, shaving of the bowel endometriosis nodule and full-thickness vaginal wall excision along with the infiltrating nodule. The infiltrating endometriosis nodule was split into two halves and was excised individually. Her postoperative VAS score for dysmenorrhea was 2/10, and she is 28 weeks pregnant at the time of submission. Advanced VR imaging can help in the evaluation and management of deep endometriosis. It can improve the surgeon’s understanding of the specific anatomy, visualise the disease, and improve clinical outcomes.
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spelling doaj-art-2f80b9cdda844ce8934c94cd7fa106dc2025-08-20T03:07:31ZengWileyCase Reports in Obstetrics and Gynecology2090-66922025-01-01202510.1155/crog/5513823Two-Step Parametrial Endometriosis Nodule Excision Using Virtual Reality Technology and 3D Modelling for Surgical PlanningRooma Sinha0Sukhbir Singh1Teresa Flaxman2Department of Gynaecology and Robotic SurgeryDepartment of ObstetricsClinical Epidemiology ProgramExtensive and infiltrative fibrous adhesions of the uterus and ovaries to the surrounding organs make surgical interventions in endometriosis challenging. A preoperative identification of these involvements can help the surgeon better prepare for the surgery. Traditionally, ultrasonography and magnetic resonance imaging (MRI) have been used. However, clinical use of modern VR technology for creating and visualising a three-dimensional (3D) digital model for a complex surgical case has been proposed. We describe a case of a 29-year-old who presented with dyspareunia and dysmenorrhea (VAS score of 10/10) with left parametrial endometriosis and created a 3D model from their two-dimensional (2D) DICOM images. A left parametrial endometriosis nodule was identified involving the left ureter, rectum, and vaginal fornix along with mucosa. A virtual preoperative surgery was done for precise and complete excision of the disease and to prevent injury to the left ureter and rectum. The surgery was performed as a two-step excision using a da Vinci Xi robot and included left ureterolysis, shaving of the bowel endometriosis nodule and full-thickness vaginal wall excision along with the infiltrating nodule. The infiltrating endometriosis nodule was split into two halves and was excised individually. Her postoperative VAS score for dysmenorrhea was 2/10, and she is 28 weeks pregnant at the time of submission. Advanced VR imaging can help in the evaluation and management of deep endometriosis. It can improve the surgeon’s understanding of the specific anatomy, visualise the disease, and improve clinical outcomes.http://dx.doi.org/10.1155/crog/5513823
spellingShingle Rooma Sinha
Sukhbir Singh
Teresa Flaxman
Two-Step Parametrial Endometriosis Nodule Excision Using Virtual Reality Technology and 3D Modelling for Surgical Planning
Case Reports in Obstetrics and Gynecology
title Two-Step Parametrial Endometriosis Nodule Excision Using Virtual Reality Technology and 3D Modelling for Surgical Planning
title_full Two-Step Parametrial Endometriosis Nodule Excision Using Virtual Reality Technology and 3D Modelling for Surgical Planning
title_fullStr Two-Step Parametrial Endometriosis Nodule Excision Using Virtual Reality Technology and 3D Modelling for Surgical Planning
title_full_unstemmed Two-Step Parametrial Endometriosis Nodule Excision Using Virtual Reality Technology and 3D Modelling for Surgical Planning
title_short Two-Step Parametrial Endometriosis Nodule Excision Using Virtual Reality Technology and 3D Modelling for Surgical Planning
title_sort two step parametrial endometriosis nodule excision using virtual reality technology and 3d modelling for surgical planning
url http://dx.doi.org/10.1155/crog/5513823
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AT sukhbirsingh twostepparametrialendometriosisnoduleexcisionusingvirtualrealitytechnologyand3dmodellingforsurgicalplanning
AT teresaflaxman twostepparametrialendometriosisnoduleexcisionusingvirtualrealitytechnologyand3dmodellingforsurgicalplanning