Laparoscopic mesentery-sparing NOSE bowel resection for endometriosis: when and how?
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This paper discusses the application and technique of laparoscopic, no-scar, endometriosis bowel resection that spares the mesentery.
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Abstract
OBJECTIVE: To describe the peri-operative considerations and surgical steps for a laparoscopic segmental resection for colorectal endometriosis, using a nerve-sparing, mesentery-sparing, and natural orifice specimen extraction (NOSE) technique.
DESIGN: Narrated surgical video within a tertiary care hospital. Institutional review board approval was not necessary for this article in accordance with the Tri-Council Policy Statement of Canada, article 2.5.
SUBJECTS: Recorded case of a 5-cm deep rectal nodule requiring resection.
EXPOSURE: Laparoscopic segmental resection.
MAIN OUTCOME MEASURES: Overview of bowel endometriosis, surgical approaches, peri-operative care, and surgical steps.
RESULTS: The surgical approach is illustrated in 8 steps: mobilization of the adnexa and cul-de-sac, bilateral ureterolysis, dissection of the pararectal and rectovaginal spaces, mesenteric dissection ± sigmoid mobilization, enterotomies and anvil placement, segmental resection and natural orifice specimen extraction, reanastomosis, and rigid sigmoidoscopy. Peri-operative care should align with the Enhanced Recovery After Surgery pathway for colorectal surgery.
CONCLUSION: In cases of multiorgan endometriosis, gynecologic surgeons must remain at the forefront of clinical decision making and surgical care coordination. The standardization of the surgical approach allows for a safe and reproducible performance of the intervention.
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References (8)
- Bowel complications in endometriosis surgery via openalex
- Bowel endometriosis: diagnosis and management via openalex
- Deep endometriosis infiltrating the recto-sigmoid: critical factors to consider before management via openalex
- Imaging of intestinal involvement in endometriosis via openalex
- Natural Orifice Specimen Extraction as a Promising Alternative for Minilaparotomy in Bowel Resection Due to Endometriosis: A Systematic Review and Meta-Analysis via openalex
- Natural Orifice Specimen Extraction Colorectal Resection for Deep Endometriosis: A 50 Case Series via openalex
- Voiding dysfunction after surgery for colorectal deep infiltrating endometriosis: an updated systematic review and meta-analysis via openalex
- W4211229530 via openalex
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Source provenance
- europepmc
- last seen: 2026-08-02T06:10:09.037253+00:00
- openalex
- last seen: 2026-06-10T17:14:06.276822+00:00
- pubmed
- last seen: 2026-08-02T06:06:43.864775+00:00
- unpaywall
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License: CC0
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