LAUSR

OBJECTIVE To describe a stepwise approach to the laparoscopic excision of bladder endometriosis. DESIGN Narrated surgical video. SETTING Academic tertiary care hospital. PATIENT(S) Surgical footage was obtained from three patients who underwent surgery for bladder endometriosis. Institutional review board approval was not required in accordance with the Tri-Council Policy Statement of Canada, article 2.5. INTERVENTION(S) Laparoscopic excision of bladder endometriotic nodules by partial cystectomy. MAIN OUTCOME MEASURE(S) Overview of the relevant anatomy, disease overview, surgical planning and perioperative care, and the approach to the excision of bladder endometriotic nodules. RESULT(S) The approach to excision of bladder endometriotic nodules can be standardized in six reproducible steps: cystoscopy with or without ureteral stent placement; abdominal survey and treatment of posterior compartment disease; bladder mobilization; partial bladder cystectomy under cystoscopic guidance; cystotomy closure; and water-leak test. CONCLUSION(S) The safe and complete excision of bladder endometriosis relies on the understanding of surgical anatomy, the multidisciplinary aspect of patient care, and the standardization of the surgical approach.