{"paper_id":"a70c0546-a1d7-4c8d-ba97-f1a738133e77","body_text":"Abstract\nIntroduction\nIntraoperative rectal perforation is an uncommon complication of pelvic surgery, which can be life-threatening and often leads to high morbidity and stoma formation rate.\nPurpose\nNo consensus has been reached regarding a standard of care for intraoperative iatrogenic pelvic injury. This article presents a technique for a stapled repair to completely resect a full-thickness low rectal perforation during robotic surgery for advanced endometriosis and avoid a high-risk colorectal anastomosis and the possible need for stoma formation.\nConclusion\nStapled discoid excision is a novel and safe technique for the repair of intraoperative rectal injuries, showing multiple benefits compared to the standard colorectal resection with or without anastomosis.\nReferences\nvan der Voort M, Heijnsdijk EA, Gouma DJ (2004) Bowel injury as a complication of laparoscopy. Br J Surg 91(10):1253–1258. https://doi.org/10.1002/bjs.4716\nLevine JH, Longo WE, Pruitt C, Mazuski JE, Shapiro MJ, Durham RM (1996) Management of selected rectal injuries by primary repair. Am J Surg 172(5):575. https://doi.org/10.1016/S0002-9610(96)00244-9\nNezhat C, Nezhat F, Pennington E, Nezhat CH, Ambroze W (1994) Laparoscopic disk excision and primary repair of the anterior rectal wall for the treatment of full-thickness bowel endometriosis. Surg Endosc 8(6):682–685. https://doi.org/10.1007/BF00678566\nGordon SJ, Maher PJ, Woods R (2001) Use of the CEEA stapler to avoid ultra-low segmental resection of a full-thickness rectal endometriotic nodule. J Am Assoc Gynecol Laparosc 8(2):312–316. https://doi.org/10.1016/s1074-3804(05)60598-1\nRoman H, Bridoux V, Tuech JJ, Marpeau L, da Costa C, Savoye G, Puscasiu L (2013) Bowel dysfunction before and after surgery for endometriosis. Am J Obstet Gynecol 209(6):524-530. https://doi.org/10.1016/j.ajog.2013.04.015\nLlarena NC, Shah AB, Milad MP (2015) Bowel injury in gynecologic laparoscopy: a systematic review. Obstet Gynecol 125(6):1407–1417. https://doi.org/10.1097/AOG.0000000000000855\nRocco B, Giorgia G, Simone A, Tommaso C, Mattia S, Stefano T, Ahmed E, Giorgio B, De Concilio B, Celia A, Salvatore M, Sighinolfi MC (2022) Rectal perforation during pelvic surgery. Eur Urol Open Sci 28(44):54–59. https://doi.org/10.1016/j.euros.2022.04.006\nLeevan E, Carmichael JC (2019) Iatrogenic bowel injury. Semin Colon Rectal Surg 30:100688. https://doi.org/10.1016/J.SCRS.2019.100688\nKaradag MA, Cecen K, Demir A, Bagcioglu M, Kocaaslan R, Kadioglu TC (2015) Gastrointestinal complications of laparoscopic/robot-assisted urologic surgery and a review of the literature. J Clin Med Res 7(4):203. https://doi.org/10.14740/jocmr2090w\nEthics declarations\nPatient consent\nConsent from the patient was obtained for photographic and video material to be used in educational publications intended for health professionals.\nConflicts of interest\nThe authors declare no competing interests.\nAdditional information\nPublisher’s note\nSpringer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.\nSupplementary information\nESM 1\nRights and permissions\nAbout this article\nCite this article\nManzo, C.A., Celentano, V. Stapled disc excision for the repair of intraoperative rectal injury during robotic surgery for deep infiltrating endometriosis. Langenbecks Arch Surg 408, 153 (2023). https://doi.org/10.1007/s00423-023-02890-9\nReceived:\nAccepted:\nPublished:\nVersion of record:\nDOI: https://doi.org/10.1007/s00423-023-02890-9","source_license":"CC0","license_restricted":false}