En Bloc Hysterectomy with segmental bowel resection by NOSE-procedure: Surgical Management of Ovarian Cancer in context of Deep Infiltrating Endometriosis

OBJECTIVE: To show the safety of en bloc hysterectomy with segmental bowel resection using the NOSE technique in the management of ovarian cancer and deep infiltrating endometriosis (DIE). DESIGN: Demonstration of the technique with narrated video. SETTINGS: Endometriosis, particularly endometriomas, increases the risk of epithelial ovarian cancer and complicates surgical management [1,2]. En bloc hysterectomy with NOSE-assisted anastomosis offers a less invasive, effective alternative, improving outcomes and recovery. PARTICIPANT: A 39-year-old patient with DIE and an adnexal mass (ORADS-4) [3,4], diagnosed with endometrioid adenocarcinoma involving both ovaries (FIGO-Stage-IIB) [5]. INTERVENTIONS: Laparoscopic en bloc hysterectomy with bowel resection and cytoreduction was performed, with intestinal anastomosis through the NOSE technique. CONCLUSIONS: En bloc hysterectomy with NOSE anastomosis reduces morbidity, enhances visualization and recovery, and achieves effective cytoreduction, offering a less invasive option for ovarian cancer with DIE.