Surgery for Deep Endometriosis: Standardization of the Operating Technique

Limberger LF, L Jacobsen, Koshimizu Rt, Siqueira DP, Rosa Alves NJD
In: Journal of Surgery and Operative Care · 2018 · vol. 3(2) · doi:10.15744/2455-7617.3.202 · W2896157445
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This paper describes the surgical technique for deep endometriosis, a condition significantly impacting quality of life that necessitates specialized surgeons and tertiary care centers due to high morbidity and complication rates.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This retrospective chart-review study analyzed 54 women with surgically confirmed deep infiltrating endometriosis treated by the same gynecologist and a multidisciplinary team in tertiary hospitals in Porto Alegre from 2011–2016, documenting demographics, symptoms, indications for surgery, lesion locations, procedures, complications, and spontaneous pregnancy after surgery. The cohort’s most common presentation was pain (mostly without infertility), and the most frequent lesion site was the intestine (70.4%), followed by vagina (14.8%) with uterosacral ligament and ureter each at 5.6%, and bladder at 3.7%, with 63% also having an endometrioma; 18.5% experienced some complication and 60% of infertile patients achieved spontaneous pregnancy. The authors also described a standardized laparoscopic/surgical technique including systematic pelvic anatomy re-establishment, ureter release, pararectal space opening, and tailored bowel resection approaches (shaving/discoid vs continuous suturing/stapled discoid resection, plus suprapubic extraction when needed). A major limitation stated by implication is that outcomes are based on a single-surgeon experience and retrospective medical-record data, which may affect generalizability. This paper is centrally about endometriosis—specifically deep infiltrating endometriosis and standardization of operative technique for lesions involving the intestine, rectovaginal septum, uterosacral ligaments, bladder, and ureters.

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Abstract

Deep endometriosis is a disease with a great negative impact on patient quality of life, requiring surgical treatment in tertiary centers and surgeons highly skilled in performing complex surgeries, and is associated with high rates of morbidity and related complications.

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Condition tags

endometriosis

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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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