Robotic Hybrid Technique in Rectal Surgery for Deep Pelvic Endometriosis

Diletta Cassini, Guido Cerullo, Michelangelo Miccini, Farshad Manoochehri, Alfredo Ercoli, Gianandrea Baldazzi, Giànandrea Baldazzi
Surgical innovation · 2013 · vol. 21(1) , pp. 52–58 · doi:10.1177/1553350613487804 · PMID:23657477 · W2129429850
article OA: closed CC0 ⤵ 12 in-corpus citations
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This study analyzed the indications, feasibility, and short-term results of robotic-assisted laparoscopic colorectal resection in 19 women with deep pelvic endometriosis, finding it a feasible and safe procedure with low complication rates.

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Abstract

BACKGROUND: Deep pelvic endometriosis is a complex disorder that affects 6% to 12% of all women in childbearing age. The incidence of bowel endometriosis ranges between 5.3% and 12%, with rectum and sigma being the most frequently involved tracts, accounting for about 80% of cases. It has been reported that segmental colorectal resection is the best surgical option in terms of recurrence rate and improvement of symptoms. The aim of this study is to analyze indications, feasibility, limits, and short-term results of robotic (Da Vinci Surgical System)-assisted laparoscopic rectal sigmoidectomy for the treatment of deep pelvic endometriosis. PATIENTS AND METHODS: Between January 2006 and December 2010, 19 women with bowel endometriosis underwent colorectal resection through the robotic-assisted laparoscopic approach. Intraoperative and postoperative data were collected. All procedures were performed in a single center and short-term complications were evaluated. RESULTS: Nineteen robotic-assisted laparoscopic colorectal resections for infiltrating endometriosis were achieved. Additional procedures were performed in 7 patients (37%). No laparotomic conversion was performed. No intraoperative complications were observed. The mean operative time was 370 minutes (range = 250-720 minutes), and the estimated blood loss was 250 mL (range = 50-350 mL). The overall complication rate was 10% (2 rectovaginal fistulae). CONCLUSIONS: Deep pelvic endometriosis is a benign condition but may have substantial impact on quality of life due to severe pelvic symptoms. We believe that robotic-assisted laparoscopic colorectal resection is a feasible and relatively safe procedure in the context of close collaboration between gynecologists and surgeons for treatment of deep pelvic endometriosis with intestinal involvement, with low rates of complications and significant improvement of intestinal symptoms.

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Condition tags

endometriosisbowel_endometriosis

MeSH descriptors

Endometriosis Laparoscopy Rectal Diseases Rectum Robotics Adult Blood Loss, Surgical Blood Loss, Surgical Endometriosis Female Humans Laparoscopy Middle Aged Operative Time Postoperative Complications Postoperative Complications Rectal Diseases Rectum Treatment Outcome

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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.

References (39)

Cited by (12)

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License: CC0 · commercial use OK