LAPAROSCOPICALLY ASSISTED VAGINAL RESECTION OF RECTOVAGINAL ENDOMETRIOSIS

Marc Possover, Herbert Diebolder, Karin Plaul, Achim Schneider
In: Obstetrics & Gynecology · 2000 · vol. 96(2) , pp. 304–307 · doi:10.1097/00006250-200008000-00029 · W4237288130
article OA: closed CC0 ⤵ 24 in-corpus citations
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-09 ⓘ

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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⚙ AI-generated deep summary by qwen3.7-flash, 2026-08-17 · read from full text ⓘ

This study evaluates a surgical technique combining laparoscopic and vaginal approaches to treat deep endometriosis involving the rectovaginal septum and extensive rectal infiltration. The procedure involves initial transvaginal excision followed by laparoscopic dissection of pararectal spaces, with rectal transection performed using stapling devices and anastomosis completed via a suprapubic minilaparotomy. In a cohort of thirty-four women, the method demonstrated safety with no major complications or need for permanent stomas, while preserving bowel, bladder, and fertility functions. This paper is centrally about endometriosis — specifically the laparoscopic-assisted vaginal resection of deep infiltrating rectovaginal lesions.

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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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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.

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Condition tags

endometriosisbowel_endometriosis

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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