An advanced flexible laparoscope with wide optic angle for observing diaphragmatic lesions associated with catamenial pneumothorax.
OBJECTIVE
To explore diaphragmatic lesions that are potentially associated with catamenial pneumothorax by using an advanced flexible laparoscope with wide optic angle.


METHODS
Case report.


METHODS
University hospital.


METHODS
A 30-year-old woman who was scheduled for thoracoscopic surgery because of recurrent right-sided catamenial pneumothorax.


METHODS
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.


METHODS
Lesions associated with endometriosis on the peritoneal surface of the posterior diaphragm abutting the posterior abdominal wall and liver.


RESULTS
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.


CONCLUSIONS
By using the flexible laparoscope, endometriotic lesions potentially related to catamenial pneumothorax were identified on the posterior diaphragm.
D000328:Adult; D004715:Endometriosis / Q000473:pathology*; D004867:Equipment Design; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000295:instrumentation*; D020706:Laparoscopes; D011030:Pneumothorax / Q000473:pathology*; D013577:Syndrome; D013906:Thoracoscopy / Q000379:methods*