Transvaginal-laparoscopic Anterior Rectum Resection in a Hysterectomized Woman with Deep-infiltrating Endometriosis: Description of a Gynecologic Natural Orifice Transendoluminal Surgery Approach

Ebert AD, Andreas D Ebert, Tilo Burkhardt, Burkhardt T, Parlayan S, Semra Parlayan, Hartwig Riediger, Papadopoulos T, Thomas Papadopoulos
Journal of Minimally Invasive Gynecology · 2009 · vol. 16(2) , pp. 231–235 · doi:10.1016/j.jmig.2008.12.011 · PMID:19249717 · W2086522506
article OA: closed CC0 ⤵ 1 in-corpus citation
View on OpenAlex View on PubMed View at publisher
⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This paper describes a transvaginal-laparoscopic approach for anterior rectal resection in a hysterectomized patient with deep-infiltrating endometriosis.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

Abstract

Deep-infiltrating endometriosis may affect the vagina, the rectum, and the cervicoisthmic part of the uterus, resulting in severe pain, particularly dyschezia, dysmenorrhea, dyspareunia, and diminished quality of life. Advanced surgical techniques, such as laparoscopic-assisted anterior rectum resection, are recognized as safe and effective therapeutic approaches. In some cases, a laparotomy or minilaparotomy has to be performed for technical reasons. This can be avoided in some cases by transvaginal-laparoscopic low anterior rectum resection. The technique is a 4-step procedure, which can be described as follows: step 1 (vaginal) - rectovaginal examination, preparation of the rectovaginal septum, opening of the pouch of Douglas, mobilization of the endometriotic nodule and the rectum, temporary vaginal closure; step 2 (laparoscopic) - removal of additional endometriotic lesions, adhesiolysis, final mobilization of the rectum, mobilization of the rectosigmoid, endoscopic resection using an endoscopic stapler step 3 (vaginal) - transvaginal resection of the lesion, preparation of the oral anvil, closure of the vagina; and step 4 (laparoscopic) - endoscopic transanal stapler anastomosis and underwater rectoscopy, prophylaxis of adhesions, drainage. We used this procedure to treat a 46-year-old woman (gravida 2, para 2) who was admitted to our hospital for severe lower abdominal pain, constipation, dyspareunia, dyschezia, and cyclic rectal bleedings. The symptoms were caused by an endometriotic nodule accompanied by a palpable rectum stenosis. In addition, she reported a past abdominal hysterectomy with complications caused by symptomatic myomatous uterus. As a gynecologic natural orifice surgery approach, the transvaginal-laparoscopic anterior rectum resection may be an additional useful surgical technique that could be offered by surgical gynecologists to some women with deep-infiltrating endometriosis.

My notes (saved in your browser only)

Condition tags

endometriosis

MeSH descriptors

Colpotomy Endometriosis Laparoscopy Rectal Diseases Colpotomy Digestive System Surgical Procedures Digestive System Surgical Procedures Douglas' Pouch Douglas' Pouch Endometriosis Endometriosis Female Humans Laparoscopy Middle Aged Rectal Diseases Rectal Diseases

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.

References (31)

Cited by (1)

Source provenance

europepmc
last seen: 2026-07-28T06:14:09.330459+00:00
openalex
last seen: 2026-06-10T17:14:06.276822+00:00
pubmed
last seen: 2026-05-13T22:14:11.755070+00:00
License: CC0 · commercial use OK