Audit and an evaluation of Laparoscopic surgery with Harmonic scalpel for Recto-vaginal Endometriosis at Inkosi Albert Luthuli Central Hospital, an endoscopic based tertiary referral centre

Mchunu Makaya, Dr Sr Ramphal


A fair proportion of women referred to our endoscopic clinic have recto-vaginal endometriosis. Complete resolution of endometriosis is not yet possible and the current therapy has three main objectives: to reduce pain, to increase the possibility of pregnancy and to delay recurrence of the disease as long as possible. There are no randomized clinical trials comparing medical versus surgical treatment, but generally, surgery is the gold standard. Laparoscopic surgery is not only challenging, but associated with major morbidity and sometimes conversion to laparotomy when addressing deep infiltrating endometriosis. Literature is sparse regarding surgery outcomes of recto-vaginal endometriosis using harmonic scalpel.

In our study, we wish to audit and evaluate laparoscopic surgery done for recto – vaginal endometriosis using harmonic scalpel (HS). All cases of recto-vaginal endometriosis surgery done at IALCH will be analyzed with respect to age, parity, referral pattern, and presenting complaints. Investigations done, work-up for surgery and surgery details will be evaluated. Complications viz. intra-operative, post operative and long term follow up will be documented. All the information will be entered into a data sheet form for analysis (see appendix A)

Primary objectives will include referral patterns, performed pre-operative investigations, surgery, intra-operative and post operative complications. Secondary objectives will be assessmenent of patient’s symptoms and use of adjunctive medical therapy.

Data will be entered into a data sheet and analyzed with the assistance of statistician. SPSS version 15 will be used for analysis of data.