An advanced flexible laparoscope with wide optic angle for observing diaphragmatic lesions associated with catamenial pneumothorax

Fertil Steril. 2008 Oct;90(4):1200.e11-4. doi: 10.1016/j.fertnstert.2007.09.023. Epub 2007 Dec 26.


Objective: To explore diaphragmatic lesions that are potentially associated with catamenial pneumothorax by using an advanced flexible laparoscope with wide optic angle.

Design: Case report.

Setting: University hospital.

Patient(s): A 30-year-old woman who was scheduled for thoracoscopic surgery because of recurrent right-sided catamenial pneumothorax.

Intervention(s): The peritoneal surface of the diaphragm was explored with an advanced flexible laparoscope that was equipped with a charge-coupled device on the tip, concurrently with thoracoscopic surgery.

Main outcome measure(s): Lesions associated with endometriosis on the peritoneal surface of the posterior diaphragm abutting the posterior abdominal wall and liver.

Result(s): When the flexible laparoscope was inserted via an umbilical trocar and the peritoneal surface of the right-sided diaphragm was explored, guided by illumination from the thoracoscope, scattered specific lattice lesions and fenestrations were identified in the central tendon of the posterior diaphragm, a region that cannot be visualized with the conventional rigid laparoscope.

Conclusion(s): By using the flexible laparoscope, endometriotic lesions potentially related to catamenial pneumothorax were identified on the posterior diaphragm.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Endometriosis / pathology*
  • Equipment Design
  • Female
  • Humans
  • Image Enhancement / instrumentation*
  • Laparoscopes*
  • Pneumothorax / pathology*
  • Syndrome
  • Thoracoscopy / methods*