Darmendometriose – Operative Möglichkeiten und Techniken

The paper discusses surgical operative options and techniques for bowel endometriosis, focusing particularly on colorectal and rectal disease, describing how operative strategy should differ from surgery for other inflammatory or malignant bowel conditions. Based on invasion depth and lesion volume, it outlines three resection approaches: mucosa-sparing resection when the seromuscularis/muscularis is involved without mucosal infiltration, disk resection for full-thickness infiltration, and segment resection for extensive stenosing involvement (with mesenterial and lymphatic handling framed as not requiring expansion beyond what is needed). The key finding is that the goal is complete removal of the endometriotic lesion from the bowel wall with minimal trauma, and it cautions that “gold standard” bowel cancer/inflammatory procedures should not be used except in rare situations, highlighting hypogastric nerve injury risk and potential lifelong functional impairment if pelvic nerve-damaging devascularization is performed. This paper is centrally about endometriosis — it provides operative possibilities and technique guidance specifically for deep colorectal/rectal endometriosis.

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