Fertility sparing double discoid excision of rectosigmoid deep endometriosis under robotic-integrated ultrasound guidance

OBJECTIVE: To present the use of robotic-integrated ultrasound for performing a double discoid excision of multifocal rectosigmoid endometriosis. DESIGN: Video article. STATEMENT OF CONSENT: The patient included in this video gave consent for publication of the video and posting of the video online, including social media, journal website, scientific literature websites (such as PubMed, ScienceDirect, Scopus), and other applicable sites. PATIENT: A 26-year-old G0 woman with chronic pelvic pain, dyschezia, and dysmenorrhea refractory to medical management desired future fertility. Imaging was suggestive of deep infiltrating endometriosis involving the rectosigmoid colon. INTERVENTION: Not applicable. MAIN OUTCOME MEASURES: Double discoid excision of multifocal rectosigmoid endometriosis using robotic-integrated ultrasound. RESULTS: Not applicable. CONCLUSIONS: Performing a complete preoperative evaluation in patients with suspected endometriosis is important for determining the extent of disease and necessity of a multidisciplinary approach. Robotic-integrated ultrasound can provide additional information, including the size and depth of bowel endometriosis lesions, which can play a role in surgical decision making. Performing a double discoid excision of multifocal rectosigmoid endometriosis using robotic-integrated ultrasound is a technique that can avoid the need for a segmental bowel resection.