A new laparoscopic-transvaginal technique for rectosigmoid resection in patients with endometriosis

Fabio Ghezzi, Antonella Cromi, Cromi A, Giuseppe Ciravolo, Ciravolo G, Rampinelli F, Fabio Rampinelli, Marco Braga, Braga M, Luigi Boni
Fertility and sterility · 2008 · vol. 90(5) , pp. 1964–1968 · doi:10.1016/j.fertnstert.2007.09.002 · PMID:18163992 · W2100882812
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This paper describes a novel laparoscopic-transvaginal surgical technique for performing rectosigmoid resections specifically in patients diagnosed with endometriosis.

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Abstract

ObjectiveTo present our experience with a new technique for laparoscopic rectosigmoid resection in patients with endometriosis.DesignProspective collaborative cohort study.SettingGynecologic departments of two university hospitals.Patient(s)Thirty-three women with rectosigmoid endometriotic lesions requiring segmental bowel resection.Intervention(s)Laparoscopic intracorporeal division of the distal bowel and exteriorization of the affected segment via a colpotomy incision to complete the resection.Main outcome measure(s)Intraoperative and postoperative complications, and relief from symptoms.Result(s)The only intraoperative complication was bleeding from the inferior mesenteric artery that required conversion to laparotomy to obtain hemostasis. No patient required a temporary colostomy. No anastomotic complications were identified. Postoperative complications included a symptomatic pelvic seroma that required operative drainage in 1 patient and urinary retention that required intermittent self-catheterization in 3 women. The median follow-up duration was 13 months (range, 3-27 mo). Twenty-seven women were symptom free at the time of last follow-up evaluation. No patient had recurrent cyclic rectal bleeding, rectal pain on defecation, or tenesmus. Postoperatively, 4 of 13 patients who tried to conceive were successful.Conclusion(s)Segmental colorectal resection with a combined laparoscopic-transvaginal approach, avoiding the extension of port-site incisions, represents a viable option for the treatment of bowel endometriosis.

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Condition tags

endometriosis

MeSH descriptors

Colectomy Colpotomy Colpotomy Endometriosis Laparoscopy Laparoscopy Rectal Diseases Sigmoid Diseases Adult Colectomy Colectomy Endometriosis Feasibility Studies Female Humans Italy Pregnancy Pregnancy Rate Prospective Studies Rectal Diseases

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