LAPAROSCOPICALLY ASSISTED VAGINAL RESECTION OF RECTOVAGINAL ENDOMETRIOSIS
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This study describes a combined laparoscopic and vaginal surgical technique for extensive rectovaginal endometriosis, which was successfully performed on 34 women without major complications, ileostomy, or colostomy.
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Abstract
In Brief Background We wanted to establish a technique of laparoscopically assisted radical vaginal surgery for deep endometriosis of the rectovaginal septum with extensive rectal involvement. Technique The procedure is started by vaginally excising the involved area which is left on the rectum, followed by bilateral dissection of the pararectal and retrorectal spaces. Para- and retrosigmoido-rectal spaces are developed laparoscopically along the coccygeosacral bone and medially to the pelvic splanchnic nerves toward the para- and retrorectal openings that were made transvaginally. Rectal transection is done with a laparoscopic stapling device caudal to the endometriotic lesion. Using a suprapubic minilaparotomy, the bowel is transected cranial to the lesion and reintroduced into the abdomen, and a transanal circular stapler anastomosis is done. Experience Thirty-four women had this procedure. The mean distance of the anastomosis was 4 cm above the anus. None required ileostomy or colostomy and no major complications were noted. Conclusion The combination of laparoscopic and vaginal approaches is useful for removing extensive endometriotic infiltration of the rectosigmoid; bladder and rectal function and fertility can be preserved. A combined laparoscopic-vaginal approach can be used in surgical treatment of rectovaginal endometriosis.
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References (5)
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- Laparoscopic treatment of infiltrative rectosigmoid colon and rectovaginal septum endometriosis by the technique of videolaparoscopy and the CO<sub>2</sub> laser via openalex
- Surgery: Rectovaginal septum, endometriosis or adenomyosis: laparoscopic management in a series of 231 patients via openalex
- W67744482 via openalex
- W2049415140 via openalex
Cited by (24)
- Different segmental resection techniques and postoperative complications in patients with colorectal endometriosis: A systematic review 2022
- Resection of the posterior vaginal fornix and retrocervical endometriotic lesions in the median part of the pelvis 2022
- Feasibility and safety of two different surgical routes for the eradication of recto‐vaginal endometriosis with vaginal mucosa infiltration (Endo‐Vag‐r study) 2020
- Endometriosis and adenomyosis 2018
- Management of deep infiltrating endometriosis of the rectum: Is a systematic temporary stoma relevant? 2017
- Combined vaginal-laparoscopic-transanal approach for reducing bladder dysfunction after conservative surgery in large deep rectovaginal endometriosis 2016
- National German Guideline (S2k): Guideline for the Diagnosis and Treatment of Endometriosis 2014
- Endometriosis: surgical approaches to stages III and IV 2014
- Técnica laparoscópica reversa en el manejo quirúrgico de la endometriosis profunda del tabique rectovaginal: experiencia preliminar 2012
- Diagnosis and treatment of rectovaginal endometriosis: an overview 2012
- Patient's fertility desire should be taken into consideration in the surgical treatment algorithm of infiltrating endometriosis 2009
- Should the Gynecologist Perform Laparoscopic Bowel Resection to Treat Endometriosis? Results Over 7 Years in 168 Patients 2009
- Laparoscopic excision of rectovaginal endometriosis: report of a prospective study and review of the literature 2009
- Transvaginal-laparoscopic Anterior Rectum Resection in a Hysterectomized Woman with Deep-infiltrating Endometriosis: Description of a Gynecologic Natural Orifice Transendoluminal Surgery Approach 2009
- Endorectal ultrasound accuracy in the diagnosis of rectal endometriosis infiltration depth 2007
- Clinical pitfalls of pain recurrence in endometriosis arising in the posterior vaginal fornix 2007
- Surgical outcome and long‐term follow up after laparoscopic rectosigmoid resection in women with deep infiltrating endometriosis 2007
- RECTAL ENDOMETRIOSIS: RESULTS OF RADICAL EXCISION AND REVIEW OF PUBLISHED WORK 2007
- Surgery for Gastrointestinal Endometriosis: Indications and Results 2006
- Treatment of rectosigmoid endometriosis by laparoscopically assisted vaginal rectosigmoidectomy 2005
- Fertility after laparoscopic colorectal resection for endometriosis: preliminary results 2005
- Surgical Management of Deeply Infiltrating Endometriosis: An Update 2004
- Endometriose de septo retovaginal: doença de diagnóstico e tratamento específicos 2003
- Research Aspects of Endometriosis Surgery 2002
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