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Segmental bowel resection and transanal specimen extraction for Deep Infiltrating Endometriosis (DIE)

Epublication WebSurg.com, Jul 2012;12(07). URL: http://websurg.com/doi/vd01en3714

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  • 2012-07-17
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Endometriosis can affect the bowel in 5-15% of cases and the most common sites are the rectum, the sigmoid colon, the appendix, and the small bowel. Patients may present dysmenorrhea, dyspareunia and chronic pelvic pain, as well as digestive symptoms such as dyschezia, constipation and diarrhea during menstruation. Preoperative work-up includes transanal ultrasound and magnetic resonance imaging, which according to the nodule’s location, can accurately describe the lesions. The laparoscopic approach includes adhesiolysis (shaving), partial thickness wall excision (mucosal skinning), discoid resection, and segmental bowel resection. In this video, we present the case of a 30-year-old patient complaining from severe dysmenorrhea, dyspareunia and dyschezia associated with deep infiltrating endometriosis (DIE) of the sigmoid colon that was treated by means of nodule excision, segmental bowel resection, and transanal specimen extraction.