Ajao Mobolaji O, Clark Nisse V, Kelil Tatiana, Cohen Sarah L, Einarsson Jon I
Division of Minimally Invasive Gynecologic Surgery, Brigham and Women's Hospital, Boston, Massachusetts.
Division of Minimally Invasive Gynecologic Surgery, Brigham and Women's Hospital, Boston, Massachusetts.
J Minim Invasive Gynecol. 2017 Nov-Dec;24(7):1239-1242. doi: 10.1016/j.jmig.2017.06.006. Epub 2017 Jun 19.
The combination of a thorough physical examination and imaging with either magnetic resonance imaging (MRI) or pelvic ultrasound are important in the preoperative planning for deep infiltrating endometriosis (DIE). A 2-dimensional (2D) rendering of the pathology by imaging does not always accurately represent intraoperative findings. The detailed topographical relationship and extent of surrounding tissue invasion can be better appreciated by 3-dimensional (3D) modeling. A 49-year-old patient with history of endometriosis and persistent pain underwent preoperative MRI that showed features consistent with DIE endometriosis. Surgery was performed, and the findings were documented. A 3D printed model of the DIE was generated from the MRI and retrospectively compared with intraoperative findings. The 3D model demonstrated both the laterality and spatial relationship of the endometriotic nodule to the posterior uterine wall and rectum. Three-dimensional printing of DIE may be a beneficial adjunct to 2D imaging and can identify further structural relationships to support surgical planning.