Hurni Yannick, La Torre Francesco, Barbany-Freixa Nuria, Barri-Soldevila Pere N
Department of Obstetrics, Gynecology and Reproduction, Dexeus Mujer. Dexeus University Hospital, Barcelona, Spain.
Department of Paediatrics, Obstetrics, Gynaecology and Preventive Medicine and Public Health, Faculty of Medicine, Universidad Autonoma Barcelona, Barcelona, Spain.
J Ultrasound. 2025 Aug 7. doi: 10.1007/s40477-025-01061-4.
To describe a standardized intraoperative transvaginal ultrasound (IOTVUS) technique for assessing rectosigmoid deep infiltrating endometriosis (DIE), and to explore its potential advantages in guiding real-time surgical decision-making.
This technical report outlines a stepwise protocol for performing IOTVUS during laparoscopic surgery. Following pelvic dissection and bowel mobilization, the pelvis is filled with saline to improve acoustic transmission. A 2D convex end-fire transvaginal probe is inserted to assess the rectosigmoid colon. Lesions are evaluated in multiple planes, measuring their dimensions, depth, circumferential involvement, and proximity to the anal verge. Findings are used intraoperatively to guide the choice of surgical approach-shaving, disc excision, or segmental resection.
IOTVUS provides real-time, high-resolution imaging of rectosigmoid DIE, enabling accurate characterization of lesion morphology after anatomical restoration. The technique facilitates the selection of the most appropriate surgical intervention based on objective, intraoperative assessment. It also allows post-excision verification of lesion removal.
IOTVUS is a promising, underutilized tool for intraoperative guidance in rectosigmoid DIE surgery. It supports precise lesion characterization and personalized surgical planning.
描述一种用于评估直肠乙状结肠深部浸润性子宫内膜异位症（DIE）的标准化术中经阴道超声（IOTVUS）技术，并探讨其在指导实时手术决策方面的潜在优势。
本技术报告概述了在腹腔镜手术期间进行IOTVUS的逐步方案。在盆腔解剖和肠管游离后，向盆腔内注入生理盐水以改善声学传导。插入二维凸阵端射式经阴道探头以评估直肠乙状结肠。在多个平面评估病变，测量其尺寸、深度、周向累及范围以及与肛缘的距离。术中的发现用于指导手术方式的选择——削切术、盘状切除术或节段性切除术。
IOTVUS可对直肠乙状结肠DIE进行实时、高分辨率成像，在解剖结构恢复后能够准确描述病变形态。该技术有助于根据客观的术中评估选择最合适的手术干预方式。它还能在切除后验证病变是否已被切除。
IOTVUS是一种在直肠乙状结肠DIE手术中具有前景但未得到充分利用的术中指导工具。它有助于精确描述病变特征并制定个性化的手术计划。
