New disc excision procedure for low and mid rectal endometriosis nodules using combined transanal and laparoscopic approach
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A novel combined transanal and laparoscopic technique using a stapler for disc excision of rectal endometriosis nodules can remove large specimens without a low rectal resection.
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Abstract
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 of endometriosis nodules involving the rectum. METHOD: The procedure is performed by combined laparoscopic and transanal routes. The former involves paring the area of the rectum infiltrated by the nodule, which is then made amenable to endoluminal removal using the Contour Transtar stapler to carry out a large disc excision. RESULTS: The technique can remove a specimen as large as 80 mm in diameter and can be applied to patients with infiltrating rectal endometrial nodules up to 10 cm from the anal margin and 50-60% of the rectal circumference. The procedure is probably less likely to lead to rectal stenosis and denervation than colorectal resection. CONCLUSION: This technique of transanal rectal disc excision using the Contour stapler is suitable in patients with infiltrating deep endometriosis nodules of the lower and mid rectum. It avoids a low rectal resection with its potential complications and unfavourable function.
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References (9)
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- Use of the CEEA Stapler to Avoid Ultra-Low Segmental Resection of a Full-Thickness Rectal Endometriotic Nodule via openalex
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Cited by (19)
- "A Space Odyssey" on Laparoscopic Segmental Rectosigmoid Resection for Deep Endometriosis: A Seventeen-year Retrospective Analysis of Outcomes and Postoperative Complications among 3050 Patients Treated in a Referral Center 2023
- Authors' Reply 2023
- Colorectal endometriosis: Diagnosis, surgical strategies and post-operative complications 2022
- Recommendations for a Combined Laparoscopic and Transanal Approach in Treating Deep Endometriosis of the Lower Rectum—The Rouen Technique 2021
- Manejo Quirúrgico de la Endometriosis Colorrectal 2020
- Recommendations for the surgical treatment of endometriosis. Part 2: deep endometriosis†‡¶ 2020
- Nerve-sparing laparoscopic disc excision of deep endometriosis involving the bowel: a single-center experience on 371 consecutives cases 2020
- Recommendations for the surgical treatment of endometriosis Part 2: deep endometriosis †‡¶. 2020
- Evaluation of functional outcomes after disc excision of deep endometriosis involving low and mid rectum using standardized questionnaires: a series of 80 patients 2020
- Pelvic Pain and Quality of Life Before and After Laparoscopic Bowel Resection for Rectosigmoid Endometriosis: A Prospective, Observational Study 2018
- Does surgery for deep infiltrating bowel endometriosis improve fertility? A systematic review 2017
- Pelvic organ function before and after laparoscopic bowel resection for rectosigmoid endometriosis: a prospective, observational study 2016
- Techniques in minimally invasive surgery for advanced endometriosis 2016
- Laparoscopic En Bloc Right Diaphragmatic Peritonectomy for Diaphragmatic Endometriosis According to the Sugarbaker Technique 2016
- Computed tomography-based virtual colonoscopy in the assessment of bowel endometriosis: The surgeon's point of view 2015
- Deep endometriosis infiltrating the recto-sigmoid: critical factors to consider before management 2015
- Full-Thickness Disc Excision in Deep Endometriotic Nodules of the Rectum 2015
- Deep rectal shaving using plasma energy for endometriosis causing rectal stenosis – a video vignette 2014
- Deep Rectal Shaving Followed by Transanal Disc Excision in Large Deep Endometriosis of the Lower Rectum 2014
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