851: PG SIG - Bread and Butter of the Endometriosis Surgeon: Technical Mastery in Stage IV Disease

Saturday, November 14, 2026
10:15 am - 12:15 pm

Room: RM302

Chairs: Ted T. Lee, Jessica Opoku-Anane

Faculty: Ted T. Lee, Jessica Opoku-Anane, Sukhbir S. Singh, Cara R. King

Description: Stage IV endometriosis presents some of the most challenging anatomy in gynecologic surgery, requiring precise dissection, disciplined technique, and deep familiarity with retroperitoneal and posterior compartment anatomy. This advanced surgical course focuses on the essential operative maneuvers—the true "bread and butter" of the endometriosis surgeon—that enable safe and effective management of severe disease. Through four focused, expert‑led presentations, participants will review evidence‑based techniques for adnexal preservation, pelvic sidewall dissection and parametrial release, excision of retrocervical and rectovaginal disease, and hysterectomy in the frozen pelvis. Emphasis is placed on reproducible dissection planes, ureteral and vascular safety, restoration of pelvic anatomy, and strategies to optimize surgical outcomes in complex cases. This activity is designed for surgeons seeking to strengthen their technical foundation and refine their operative approach to Stage IV endometriosis.

Learning Objectives: At the end of this course, the participant will be able to:

1. Apply foundational surgical techniques for adnexal preservation and pelvic sidewall management in severe endometriosis, including strategies for ovarian and tubal protection, decision‑making around salpingectomy, endometrioma management, and safe retroperitoneal dissection;
2. Perform advanced excisional techniques across deep pelvic compartments—including parametrial, retrocervical, and rectovaginal disease—using reliable anatomic landmarks, rectal mobilization strategies, and nerve‑sparing principles to optimize safety and functional outcomes; and
3. Integrate endometriosis excision into hysterectomy for Stage IV disease by employing structured approaches to bladder dissection, parametrial release, ureteral protection, and anatomic restoration in the frozen pelvis.

COURSE OUTLINE

10:15 AM Commanding the Lateral Pelvis: Pelvic Sidewall Dissection and Parametrectomy in Dense Fibrosis

T. Lee

10:40 AM Adnexal Preservation Mastery: Minimizing Damage, Maximizing Function

J. Opoku-Anane

11:05 AM From Known to Unknown: Safe Entry Into the Pararectal and Rectovaginal Spaces and Excision of Retro‑Cervical and Rectovaginal Endometriosis in Stage IV Disease

S. Singh

11:30 AM Hysterectomy in Severe Endometriosis: Integrating Excision for Optimal Surgical Outcomes

C. King