scholarly journals Experience with multidisciplinary laparoscopic surgery in patients with deep infiltrating colorectal endometriosis

2014 ◽  
Vol 155 (5) ◽  
pp. 182-186 ◽  
Author(s):  
Attila Bokor ◽  
Réka Brubel ◽  
Péter Lukovich ◽  
János Rigó jr.
Keyword(s):  
Bowel Resection ◽  
Rectal Resection ◽  
Colorectal Anastomosis ◽  
Sigmoid Resection ◽  
Deep Infiltrating Endometriosis ◽  
Colorectal Endometriosis ◽  
Segmental Bowel Resection ◽  
The Mean ◽  
Colorectal Resections ◽  
Infiltrating Endometriosis

Introduction: Deep infiltrating endometriosis is a particular form of endometriosis that penetrates the peritoneal surface or it reaches the subserosal neurovascular plexus. Aim: The aim of the authors was to analyze the results of segmental colorectal resections performed for deep infiltrating endometriosis. Method: Between 2009 and 2012, 50 patients underwent segmental rectum or/and sigmoid resection for endometriosis. Results: 21 patients had ultralow rectal resection and 29 patients had low colorectal anastomosis or anterior resection. Concomitant intervention in other organs was required in all cases, including gynecologic procedures (n = 50), additional gynecologic (n = 47), vesical (n = 9) and ureteral (n = 18) resections. The mean number of endometriosis lesions was 2.4±1.8 per patient. In all patients fertility was preserved. Severe surgical complications (Clavien–Dindo stage III or more severe) occurred in 3 patients (6%). Conclusions: The results confirm that segmental bowel resection is an efficient and safe method for the treatment of deep infiltrating colorectal endometriosis. Orv. Hetil., 2014, 155(5), 182–186.

scholarly journals Spontaneous Healing of a Rectovaginal Fistula Developing after Laparoscopic Segmental Bowel Resection for Intestinal Deep Infiltrating Endometriosis

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
William Kondo ◽  
Reitan Ribeiro ◽  
Carlos Henrique Trippia ◽  
Monica Tessmann Zomer
Keyword(s):  
Rectovaginal Fistula ◽  
Bowel Resection ◽  
Intestinal Anastomosis ◽  
Pelvic Abscess ◽  
Deep Infiltrating Endometriosis ◽  
Laparoscopic Treatment ◽  
Spontaneous Healing ◽  
Uterosacral Ligaments ◽  
Segmental Bowel Resection ◽  
Infiltrating Endometriosis

The surgical treatment of intestinal deep infiltrating endometriosis has an associated risk of major complications such as dehiscence of the intestinal anastomosis, pelvic abscess, and rectovaginal fistula. The management of postoperative rectovaginal fistula frequently requires a reoperation and the construction of a stoma for temporary fecal diversion. In this paper we describe a 27-year-old woman undergoing laparoscopic treatment of deep infiltrating endometriosis (extramucosal cystectomy, resection of the uterosacral ligaments, resection of the posterior vaginal fornix, and segmental bowel resection) complicated by a rectovaginal fistula, which healed spontaneously with nonsurgical conservative treatment.

Hysteroscopic vaginoscopy. An additional diagnostic tool for recto-vaginal deep infiltrating endometriosis

2020 ◽  
pp. 228402652096786
Author(s):  
Brunella Zizolfi ◽  
Virginia Foreste ◽  
Attilio Di Spiezio Sardo ◽  
Pierluigi Giampaolino ◽  
Annarita Gencarelli ◽  
...  
Keyword(s):  
Bowel Resection ◽  
Uterine Cavity ◽  
Accurate Diagnosis ◽  
Endometrial Tissue ◽  
Deep Infiltrating Endometriosis ◽  
Resonance Imaging ◽  
Total Hysterectomy ◽  
Segmental Bowel Resection ◽  
History Of ◽  
Infiltrating Endometriosis

Endometriosis is the presence of endometrial tissue outside the uterine cavity. Rectovaginal infiltration is present in 5% to 25% of the patients diagnosed with endometriosis. Accurate diagnosis is imperative for adequate counseling. Hysteroscopic vaginoscopy allows the inspection of the posterior vaginal fornix, not only providing better visualization of the area due to image magnification, but also allowing to obtain biopsy providing pathologic confirmation. We report the case of a 49-year-old nulliparous patient with long history of severe dysmenorrhea, deep dyspareunia and debilitating chronic pelvic pain not responding to medical treatment. On physical exam, recto-vaginal tender nodularity was palpated. Vaginal ultrasound and magnetic resonance imaging confirmed the presence of the nodular formation extending up to the rectum. In-office vaginoscopy revealed a perforated bulge on the uterine cervix, mimicking a double cervix. A biopsy of the nodule confirmed the presence of endometrial tissue, confirming the diagnosis of endometriosis. Patient underwent total hysterectomy with excision of deep infiltrating endometriosis which required segmental bowel resection with diverting loop colostomy. The final pathology confirmed the diagnosis of deep infiltrating endometriosis.

THE PRELIMINARY RESULTS OF OPERATION COLORECTAL ADENOMATOUS POLYPOSIS BY LAPAROSCOPY

2017 ◽  
pp. 63-68
Author(s):  
Quoc Phong Le ◽  
Nhu Hiep Pham
Keyword(s):  
Laparoscopic Surgery ◽  
Bowel Resection ◽  
Right Hemicolectomy ◽  
Adenomatous Polyposis ◽  
Operative Indication ◽  
Surgical Department ◽  
Colorectal Polyposis ◽  
Segmental Bowel Resection ◽  
The Mean ◽  
Bloody Stools

Objective: To study the clinical characteristics, paraclinic, the operative indication and treatment outcomes operation of colorectal polyposis by laparoscopic. Marterials: 12 patients with colorectal polyposis, is surgically the subtotal colectomy, and the total colorectomy by laparoscopic from 11/2012 to 4/2015 at Digestive Surgical Department of Hue Central Hospital. Method: Prospective study, all patients were examined clinically, endoscopic colorectal, operative indication, the type of surgery, lengh of post-operative stay, complications, and pathology. Results: From 11/2012 to 4/2015. We had overalled 12 patients: 8 males and 4 females, the mean patient was 36.33 ± 19.5 years of age (15-71). Dyspepsia 66.7%, bloody stools 100%. Laparoscopic segmental bowel resection in four (33,3%) cases: right hemicolectomy in one (8.3%), resection of transverse colon in one (8.3%), left hemicolectomy in two (16.7%), and totally colorectomy in eight (66.7%) by laparoscopic surgery. The mean post-operative hospital stay was 10.1 ± 3.8 days. The early complication: fistula anastomosis in one (8.3%), patients recovered after conservative treatment, no bleeding and no wound infection. The pathology is adematous polyps 91.7% and hyperplasia polyps 8.3%. Conclusion: Laparoscopic surgery is currently the technique of choice. The resection of colorectal polyposis is the method safe, effective, high success, low rate complications. Key words: laparoscopic, polyposis, colo-rectal polyposis, hemicolectomy

Robotic Natural Orifice Specimen Extraction with Totally Intracorporeal Anastomosis Associated with Firefly Fluorescence: Bowel Resection for Deep Infiltrating Endometriosis

2020 ◽  
Vol 36 (3) ◽  
pp. 128-135
Author(s):  
Andre Luiz Gioia Morrell ◽  
Gladis Maria P. Anchieta Rodrigues Ribeiro ◽  
Thiago Pareja dos Santos ◽  
Alexander Charles Morrell ◽  
Luciana Pardini Chamie ◽  
...  
Keyword(s):  
Bowel Resection ◽  
Intracorporeal Anastomosis ◽  
Deep Infiltrating Endometriosis ◽  
Natural Orifice ◽  
Specimen Extraction ◽  
Natural Orifice Specimen Extraction ◽  
Infiltrating Endometriosis

Deep infiltrating endometriosis: Interest of the robotic approach for a fledgling team

2019 ◽  
Vol 11 (3) ◽  
pp. 152-157
Author(s):  
Julie Poujois ◽  
Cécile Mézan De Malartic ◽  
Ronan Callec ◽  
Laurent Bresler ◽  
Nicolas Hubert ◽  
...  
Keyword(s):  
Laparoscopic Approach ◽  
Deep Infiltrating Endometriosis ◽  
Robotic Assistance ◽  
Deep Endometriosis ◽  
Surgical Assistance ◽  
Surgical Data ◽  
The Mean ◽  
Infiltrating Endometriosis

Introduction: Mini-invasive surgery of deep endometriosis is challenging. Surgical difficulties related to the technical limitations of classical laparoscopic approach might be overcome with the use of robotic assistance. The aim of this study was to evaluate the safety and feasibility of robotic surgery for deep infiltrating endometriosis in the learning phase of our team. Methods: The 20 first cases of robotic-assisted laparoscopies for endometriosis were included over a 2-year period. Baseline characteristics of patients and surgical data were reviewed. Surgical outcomes and follow-up information of the patients were analyzed. Results: Twenty women were included. The mean age was 31.9 years (range: 25–44) and mean body mass index was 23 kg/m2 (range: 16–35). Ten patients had rectovaginal or uterosacral location only (50%) and nine women had deep infiltrating endometriosis with digestive or urinary tract lesions (45%). In addition to the gynecologic surgeon, urologic or visceral surgeons were required in 10 cases, and there were 3 cases where the three specialties were needed. The mean operative time was 183.9 min (range: 85–398) and no difference was observed between the first five cases and the last five cases. There was one laparoconversion, and only two urologic postoperative complications occurred. Conclusion: Thanks to the use of robotic surgical assistance and a multidisciplinary approach, and despite the start of the team for deep endometriosis care, no learning curve effect was observed regarding surgical procedures’ success, safety, or duration. The use of robotic assistance might improve the quality of care for women facing deep endometriosis.

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