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Fully laparoscopic segmental rectosigmoid resection with Natural Orifice Specimen Extraction (NOSE) for bowel endometriosis

Epublication WebSurg.com, Jul 2011;11(07). URL: http://websurg.com/doi/vd01en3139

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  • 2011-07-15
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We report the case of a 45-year-old woman, G2P2, who presents with rectal bleeding, constipation and subocclusive syndrome caused by rectosigmoid endometriosis. The laparoscopic exploration revealed a sigmoid stuck by a few adhesions to the lateral abdominal wall underneath the left ovary and obliteration of the left uterosacral ligament and rectovaginal septum. A segmental bowel resection was performed with all necessary steps for mechanical bowel anastomosis carried out laparoscopically. The transvaginal specimen extraction obviated the need to create an abdominal incision. There were no complications and the patient presented a clinical remission following surgery. This surgical technique has the advantage of a shorter division of the mesentery, which enables a better vascularization of the bowel.