The feasibility of laparoscopic bowel resection performed by a gynaecologist to treat endometriosis

Pereira RM, Ricardo Pereira, Ricardo Mendes Alves Pereira, Alysson Zanatta, Zanatta A, P. Serafini, Serafini Pc, Paulo C Serafini, Redwine D, David Redwine, David B. Redwine
Current opinion in obstetrics & gynecology · 2010 · vol. 22(4) , pp. 344–353 · doi:10.1097/gco.0b013e32833beae0 · PMID:20611000 · W2002994948
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Gynaecologic surgeons may achieve satisfactory outcomes in laparoscopic bowel resection for endometriosis if adequately trained, offering potential benefits to patients and healthcare systems.

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This review evaluates the feasibility of gynecologists performing laparoscopic bowel resections for intestinal endometriosis, contrasting single-surgeon models with traditional multidisciplinary teams. The authors highlight that surgeon experience and training are critical predictive factors for procedural success, noting that both approaches yield satisfactory results regarding complications and clinical remission. While protective ostomies did not significantly reduce fistula rates in multidisciplinary settings, the paper suggests that properly trained gynecologic surgeons can safely perform these excisions, potentially offering advantages to patients and healthcare systems. This paper is centrally about endometriosis — specifically addressing surgical management strategies for deeply infiltrating lesions involving the bowel.

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Abstract

PURPOSE OF REVIEW: Intestinal endometriosis is commonly diagnosed in the setting of deeply infiltrating endometriosis. A multidisciplinary team that includes gynaecologists and general surgeons traditionally performs laparoscopic bowel resections for symptomatic patients. Recently, Pereira et al. has published the results of a series of patients who underwent laparoscopic bowel resection for endometriosis performed by a team of gynaecologic surgeons, after a period of experimental training with animals and joining participation with general surgeons in the first cases. It is suggested that gynaecologic surgeons may be able to perform laparoscopic bowel resections for endometriosis, if properly trained, although the results may not be reproducible. RECENT FINDINGS: A review of recent literature related to laparoscopic bowel resections for endometriosis showed that the learning curve and experience of the surgeon may be the most important predictive factors for the effectiveness of the procedure. Results concerning major operative complications and clinical remission were considered satisfactory in both single and multidisciplinary approaches, that is, laparoscopic bowel resections performed by gynaecologic and colorectal surgeons. Protective colostomies or ileostomies could not reduce the rate of rectovaginal fistulae in multidisciplinary experiences. SUMMARY: The single-surgeon model approach in laparoscopic excision of endometriosis that includes bowel resection may provide advantages for both the patients and healthcare system. The best model should be decided on the maximum benefit of the patient.
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The feasibility of laparoscopic bowel resection performed by a gynaecologist to treat endometriosis - Ricardo Mendes Alves Pereira - Alysson Zanatta - Paulo C Serafini - David Redwine Purpose of review Intestinal endometriosis is commonly diagnosed in the setting of deeply infiltrating endometriosis. A multidisciplinary team that includes gynaecologists and general surgeons traditionally performs laparoscopic bowel resections for symptomatic patients. Recently, Pereira et al. has published the results of a series of patients who underwent laparoscopic bowel resection for endometriosis performed by a team of gynaecologic surgeons, after a period of experimental training with animals and joining participation with general surgeons in the first cases. It is suggested that gynaecologic surgeons may be able to perform laparoscopic bowel resections for endometriosis, if properly trained, although the results may not be reproducible. Recent findings A review of recent literature related to laparoscopic bowel resections for endometriosis showed that the learning curve and experience of the surgeon may be the most important predictive factors for the effectiveness of the procedure. Results concerning major operative complications and clinical remission were considered satisfactory in both single and multidisciplinary approaches, that is, laparoscopic bowel resections performed by gynaecologic and colorectal surgeons. Protective colostomies or ileostomies could not reduce the rate of rectovaginal fistulae in multidisciplinary experiences. Summary The single-surgeon model approach in laparoscopic excision of endometriosis that includes bowel resection may provide advantages for both the patients and healthcare system. The best model should be decided on the maximum benefit of the patient.

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Condition tags

endometriosis

MeSH descriptors

Colonic Diseases Digestive System Surgical Procedures Endometriosis Laparoscopy Clinical Competence Colonic Diseases Colonic Diseases Digestive System Surgical Procedures Endometriosis Endometriosis Feasibility Studies Female Gynecologic Surgical Procedures Gynecologic Surgical Procedures Humans Laparoscopy

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.

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