Surgical laparoscopic treatment of bowel endometriosis with transvaginal resection of the rectum using ultrasonically activated shears: a retrospective cohort study with description of technique

Arch Gynecol Obstet. 2018 Apr;297(4):985-988. doi: 10.1007/s00404-018-4692-x. Epub 2018 Feb 7.

Abstract

Background: To asses the results of laparoscopic surgical treatment of bowel endometriosis with transvaginal resection of the rectum employing ultrasonic energy retrospective study.

Method: 100 patients with symptoms of narrowing or partial obstruction of colon were submitted to laparoscopic resection of rectosigmoid tract through a vaginal route. Length of surgery, blood loss, histopathological extent of rectal invasion, surgical complications, and length of hospital stay were the main analyzed outcomes.

Results: Mean operative time was 281 min, blood loss was 250 ml on average, length of stay was 8 days, bowel movements were after 3.5 days, the mean length of bowel-resected segments was 13.3 cm, the disease was multifocal in 64% and multicentric in 36% of surgical specimens.

Conclusion: Laparoscopically assisted vaginal resection of rectosigmoid colon affected by endometriosis using ultrasonically activated shears with mechanical intestinal anastomoses tension free is a safe and effective procedure for surgical management of severe pelvic endometriosis with bowel involvement.

Keywords: Bowel; Endometriosis; Laparoscopic; Resection.

MeSH terms

  • Adult
  • Anastomosis, Surgical
  • Blood Loss, Surgical
  • Colonoscopy
  • Colpotomy / methods*
  • Digestive System Surgical Procedures / methods*
  • Endometriosis / pathology
  • Endometriosis / surgery*
  • Female
  • Humans
  • Laparoscopy / instrumentation*
  • Laparoscopy / methods
  • Length of Stay
  • Pregnancy
  • Rectum / surgery*
  • Retrospective Studies
  • Treatment Outcome
  • Ultrasonics