Abstract:

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.

Key words: Rectovaginal septum, Endometriosis, Laparoscopic surgery