Roman H

The management of patients presenting deep infiltrating endometriosis involving the rectum (DIER) and pregnancy intention is controversial. Assisted Reproduction Techniques (ART) are often proposed first, but this may lead to complications …

STUDY QUESTION: What are the fertility outcomes in women wishing to conceive after experiencing a severe complication from surgical removal of colorectal endometriosis? SUMMARY ANSWER: The pregnancy rate (PR) among women who wished to conc…

UNLABELLED: National and international guidelines recommend referring patients with severe forms of endometriosis to expert centers. However, there is a lack of clear criteria to define an expert center. We examined the roles of surgeon and…

OBJECTIVE: To assess the feasibility of deep endometriosis surgery using robotic assistance, benefits and limits of this approach. METHOD: Case-series study enrolling patients managed for deep infiltrating endometriosis (DIE) using robotic…

STUDY OBJECTIVE: To assess the value of performing a protective stoma in patients operated for rectal endometriosis. MATERIAL AND METHODS: From June 2009 to December 2011, 47 patients were operated for rectal endometriosis by segmental or …

Preoperative evaluation: clinical examination, and research for associated lesions. Laparoscopic approach. Cystectomy: gold standard, conformed to the endometrioma pathophysiology (3 zones). Laser CO2 Plasmajet® vaporisation: important data…

OBJECTIVE(S): To assess fertility outcomes after ICSI-IVF in infertile women having undergone prior complete surgical removal of colorectal endometriosis. STUDY DESIGN: Prospective longitudinal cohort study in two referral French centres i…

There is molecular evidence that endometriosis has a negative impact on the ovaries, although the exact pathophysiology concerning endometriosis-associated subfertility is not known. The negative impact on the tubo-ovarian unit can be direc…

OBJECTIVE: To evaluate delivery and neonatal outcomes in women with resected or in situ bowel endometriosis. DESIGN: Retrospective cohort study. SETTING: France. POPULATION AND SAMPLE: Analysis of 72 pregnancies from 67 women followed fo…

Nerve-sparing surgery is an emerging technique for surgery-related dysfunction. Within the past 15 years, an essential progress in recognition and understanding of the anatomy of the pelvic autonomous nervous system has been made. Surgical …

One of the most interesting debates surrounding deep endometriosis concerns the management of patients with colorectal lesions and pregnancy intention, for which no strong first level of evidence data exists to recommend performing surgical…

BACKGROUND: Colorectal resection is performed in a majority of patients presenting with large endometriosis of mid and lower rectum; however, it may negatively and irreversibly impact postoperative rectal function. To avoid such unfavourabl…

BACKGROUND: To date, a majority of patients presenting with large endometriosis of the rectum are managed worldwide by colorectal resection. However, postoperative rectal function may be impacted by radical rectal surgery. OBJECTIVE: The p…

Surgical management of colorectal endometriosis follows the principles of two main philosophies or approaches: radical and conservative. The radical approach has recently been recommended in multifocal colorectal endometriosis, which freque…

STUDY QUESTION: What are the recurrence and pregnancy rates in women managed for ovarian endometrioma by ablation using plasma energy with and without associated surgery for colorectal endometriosis? SUMMARY ANSWER: Concomitant management …

STUDY OBJECTIVE: The objective was to evaluate the perioperative outcomes, safety, and patient acceptance of single-port access laparoscopic subtotal hysterectomy (SPAL-SH) in comparison with conventional multiport access laparoscopic subto…

OBJECTIVE: To investigate the impact of ovarian endometrioma vaporization using plasma energy on antimullerian hormone (AMH) level. METHOD: We report a prospective, noncomparative series (NCT01596985). Twenty-two patients with unilateral o…

STUDY OBJECTIVE: To report the combined cystoscopic and laparoscopic approach in deep endometriosis with full-thickness infiltration of the bladder. DESIGN: Video (Canadian Task Force classification III). SETTING: University hospital. PA…

STUDY OBJECTIVE: To report an original technique of deep rectal shaving using PlasmaJet (Plasma Surgical, Inc., Roswell, GA) followed by transanal disc excision using the Contour Transtar stapler (Ethicon EndoSurgery Inc., Cincinnati, OH) s…

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AIM: Colorectal resection in women with endometriosis involving the low and mid rectum may result in a poorer outcome than conservative procedures. In this technical note we present a new technique for transanal full thickness disc excision…

BACKGROUND: Numerous studies concerning endometriosis and pain have been reported. However, there is no consensus on the best method to evaluate pain in endometriosis and many scales have been used. Moreover, there are only a few descriptio…

The relationship between deep fibrotic endometriosis of the rectum and digestive symptoms as well as the impact of surgical treatment on digestive complaints appears increasingly complex. With the exception of cases in which the disease lea…