深部浸润型子宫内膜异位症（deep endometriosis，DE）是指病灶浸润深度≥5 mm。 直肠阴道隔内异症作为一种特殊类型的子宫内膜异位症，其病灶位于直肠阴道隔深部，治疗难度大，损伤风险高。 腹腔镜手术因其创伤小，恢复快及视野清晰等优势已成为首选的治疗方法。 对直肠阴道隔解剖的认识对于手术成功至关重要，充分切除病灶、重建盆腔解剖并保护重要脏器的功能为该手术的重要原则。 术前应充分告知患者手术风险及获益，必要时采取多学科协作手术。 这类手术复杂，对术者手术技巧要求高，应根据患者的年龄，生育需求、疼痛程度等制定手术方案，并采用不同的器械和手术技巧保证手术顺利完成。

Deep endometriosis （DE） refers to endometriosis lesions that have penetrated≥5 mm in depth. As a special type of endometriosis， intravaginal rectal diaphragm endometriosis has its lesions located in the deep part of the rectovaginal septum， which is difficult to treat and carries a high risk of injury.Laparoscopy has become the preferred treatment method due to its advantages of small trauma， fast recovery，and clear visualization. Understanding the anatomy of the rectovaginal diaphragm is crucial for surgery. The key principles of surgery include fully removing the lesion， reconstructing the pelvic anatomy， and protecting the function of important organs. Preoperative informed consent should be fully provided to patients regarding the risks and benefits of surgery. If necessary， multidisciplinary surgery should be performed. The surgery is complex and requires high surgical skills. Surgical procedures should be tailored according to patients' age，fertility needs， and pain levels， and different instruments and surgical techniques should be used to ensure the successful completion of the surgery.