Anterior rectal wall excision for endometriosis using the circular stapler

Rodney J Woods, Rodney Woods, Alexander G Heriot, Frank C Chen
ANZ journal of surgery · 2003 · vol. 73(8) , pp. 647–648 · doi:10.1046/j.1445-2197.2003.02706.x · PMID:12887538 · W2033846781
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Abstract

BACKGROUND: Endometriosis involving the rectum is rare but is associated with significant symptoms that are best relieved by resection of the involved segment of rectum. Resection necessitates either a segmental or anterior rectal wall excision with sutured closure. Application of a circular stapling device allows an alternative technique to resect endometriosis in this area. METHOD: Following laparoscopic ablation of endometriosis elsewhere in the pelvis, the rectum must be mobilized around disease present on the anterior rectal wall. This will involve lateral and anterior extraperitoneal rectal dissection; the latter dissection mobilizing the vagina from the rectum by a sufficient length necessary to allow imbrication of the diseased area. Insertion of a circular stapler per anus allows the diseased area to be imbricated into the stapler, resulting in simultaneous excision and closure of the anterior rectal wall. RESULTS: Thirty patients with anterior rectal wall endometriosis, estimated at one-third of the total circumference of the rectum, have undergone successful management using this technique. Morbidity occurred in four patients, with one patient requiring further surgery. CONCLUSIONS: Laparoscopic disc excision of deposits of endometriosis involving the anterior rectal wall can be safely performed utilizing the circular stapler without the need for open surgery, and with low morbidity.

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Condition tags

endometriosis

MeSH descriptors

Colectomy Endometriosis Rectal Diseases Surgical Stapling Colectomy Colectomy Endometriosis Endometriosis Female Humans Rectal Diseases Rectal Diseases Rectum Rectum Surgical Staplers Surgical Stapling Treatment Outcome

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