Objective: Laparoscopic excision of deep endometriosis of rectovaginal septum and evaluation of technical capabilities of Diomed laser. Design: Prospective pilot study. Setting: Department of Gynaecology and Minimally Invasive Surgery, Na Homolce Hospital, Pra- gue Methods: Eight patients with clinically and laparoscopically diagnosed endometriosis of the recto- vaginal septum were selected for laparoscopic surgery. The extent of the lesion was assessed by vaginal palpations and laparoscopic visualisation of the Douglas space with a sponge forceps inserted into the posterior vaginal fornix and using rectal probe simultaneously. To exclude rectal wall infiltration baryum radiography was performed. Results: 7 out of 8 patients experienced a complete disappearence of symptoms such as dyspareu- nia, dysmenorrhea and pelvic pain. Follow - up is in the range of 1 - 12 months. Summary: Deep infiltrating rectovaginal endometriosis is a specific disease very different from peritoneal or ovarian endometriosis. A more precise term is rectovaginal adenomyosis. Radical laparoscopic excision is needed. Although simple this is demanding pelvic surgery, the results are gratifying. The use of a laser seems superior to dissection technique.

        Key words: laparoscopy, endometriosis, rectovaginal septum, laser