Archives of Gynecology and Obstetrics

, Volume 297, Issue 4, pp 985–988 | Cite as

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

  • F. Rampinelli
  • P. Donarini
  • C. Visenzi
  • S. Ficarelli
  • G. Ciravolo
General Gynecology



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


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.


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.


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.


Endometriosis Laparoscopic Resection Bowel 


Author contributions

FR: Project development, Data Collection, Methods, Manuscript writing. PD: Methods, Manuscript editing, Data analysis. CV: Manuscript editing. SF: Manuscript editing. GC: Project development, Data Collection, Methods.

Compliance with ethical standards

Conflict of interest

Nothing to disclose about potential conflicts of interest.

Informed consent

No informed consent needed for this study.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors (only observational).


  1. 1.
    Chapron C, Dubuisson JB (2001) Management of deep endometriosis. Ann N Y Acad Sci 943:276–280CrossRefPubMedGoogle Scholar
  2. 2.
    Chapron C (1998) Results and role of rectal endoscopic ultrasonography for patient with deep pelvic endometriosis. Hum Reprod 13(8):2266–2270CrossRefPubMedGoogle Scholar
  3. 3.
    Possover M, Diebolder H, Plaul K, Schneider A (2000) Laparoscopically assisted vaginal resection of rectovaginal endometriosis. Obstet Gynecol 96:304–307PubMedGoogle Scholar
  4. 4.
    Ribeiro PA, Rodriguez FC, Kehdi IPA, Rossini L, Abdalla E, Donadio N, Aoki T (2006) Laparoscopic resection of intestinal endometriosis: a 5 year experience. J Min Invasive Gynecol 13:442–446CrossRefGoogle Scholar
  5. 5.
    Kavallaris A, Kohler C, Kuhne-heid R, Schneider A (2003) Histopathological extent of rectal invasion by rectovaginal endometriosis. Hum Reprod 18(6):1323–1327CrossRefPubMedGoogle Scholar
  6. 6.
    Redwine DB, Koning M, Sharpe DR (1996) Laparoscopically assisted transvaginal segmental resection of the rectosigmoid colon for endometriosis. Fertil Steril 65(1):193–197CrossRefPubMedGoogle Scholar
  7. 7.
    Chapron C, Vieira M, Chopin N, Balleyguier C, Barakat H, Dumontier I, Roseau G, Fauconnier A, Foulot H, Dousset B (2004) Accuracy of rectal endoscopic ultrasonography and magnetic resonance imaging in the diagnosis of rectal involvement for patients presenting with deeply infiltrating endometriosis. Ultrasound Obstet Gynecol 24:175–179CrossRefPubMedGoogle Scholar
  8. 8.
    Campagnacci R, Perretta M, Guerrieri M, Paganini M, De Sanctis A, Ciavattini A, Lezoche E (2005) Laparoscopic colorectal resection for endometriosis. Surg Endosc 19(662–66):4Google Scholar
  9. 9.
    Bartkowiak R, Zieniewic K, Kaminski P, Krawczyk M, Marianowski L, Szymanska K (2000) Diagnosis and treatment of sigmoidal endometriosis—a case report. Med Sci Monit 6(4):787–790PubMedGoogle Scholar
  10. 10.
    Paulson JD, Alizadeh A, Andrade R (1997) Tratamento da endometriose por laparoscopia operatoria. In: Ueno J, Santos NC, Pinheiro W, Pinotti JA (eds) Chirurgia video endoscopica em ginecologia. Roca, Sao Paulo, pp 134–145Google Scholar
  11. 11.
    Koninckx PR, Meuleman C, Demeyere C (1991) Suggestive evidence that pelvic endometriosis is a progressive disease, whereas deeply infiltrating endometriosis is associated with pelvic pain. Fertil Steril 55(759):765Google Scholar
  12. 12.
    Varol N, Maher P, Healey M, Woods R, Woods C, Hill D, Lolatgls N, Tsaltas J (2003) Rectal surgery for endometriosis. Should we be aggressive? J Am Assoc Gynecol Laparosc 10(2):182–189CrossRefPubMedGoogle Scholar
  13. 13.
    Shaw RW (1992) Treatment of endometriosis. Lancet 340:1267–1271CrossRefPubMedGoogle Scholar
  14. 14.
    Chapron C, Bourret A, Chopin N, Dousset B, Leconte M, Amsellem-Ouzana D, Ziegler D, Borghese B (2010) Surgery for bladder endometriosis: long term results and concomitant management of associated posterior deep lesions. Hum Reprod 25:884–889CrossRefPubMedGoogle Scholar
  15. 15.
    Faller E, Albornoz J, Messori P, Leroy J, Wattiez A (2013) A new technique of laparpscopic intracorporeal anastomosis for transrectal bowel resection with transvaginal specimen extraction. J Minim Invasive Gynecol 20(3):333CrossRefPubMedGoogle Scholar
  16. 16.
    Duepree H, Senagore A, Delaney C, Marcello P, Brady K, Falcone T (2002) Laparoscopic resection of deep pelvic endometriosis with resectosigmoid involvement. J Am Coll Surg 195:754–758CrossRefPubMedGoogle Scholar
  17. 17.
    Abrao MS, Goncalves MO, Dias JA, Podgaec S, Garry R, Chamie LP, Blasbailg R (2007) Comparision between clinical examination, transvaginal sonography and magnetic resonance imaging for the diagnosis of deep endometriosis. Hum Reprod 22:3092–3097CrossRefPubMedGoogle Scholar
  18. 18.
    Pronio A, Filippo A, Mancini B, Piroli S, Vestri A, Montesani C (2007) Anastomotic dehiscence in colorectalo surgery. Analysis of 1290 ptients. Chir Ital 59:599–609PubMedGoogle Scholar
  19. 19.
    Guerriero S, Ajoossa S, Gerada M, Virgilio B, Angioni S, Melis GB (2008) Diagnostic value of transvaginal tenderness guided ultrasonography for the prediction of locationdeependometriosis. Human Eprod 23:2452–2457CrossRefGoogle Scholar
  20. 20.
    Goncalves MO, Podgaec S, Dias JA, Gonzaòles M, Abrao MS (2010) Transvaginal ultrasonography with bowel preparation is able to predict the number of lesions and rectosigmoid layers affected in cases of deep endometriosis, defining surgical strategy. Hum Reprod 25:656–671CrossRefGoogle Scholar
  21. 21.
    Sang JL, Ki HP (1999) Ultrasonic energy in endoscopic surgery. Yonsei Med J 40(6):545–549CrossRefGoogle Scholar
  22. 22.
    Philips CK, Hruby GW, Durak E, Lehman DS, Humphrey PA, Mansukhani et al (2008) Tissue response to surgical energy device. Urology 71:744–748CrossRefGoogle Scholar
  23. 23.
    Litta P, Saccardi C, Gizzo S, Conte L, Ambrosi G, Sissi C, Palombo M (2015) Inflammatory cytokine expression following the use of bipolar electrocoagulation, ultracision harmonic scalpel and cold knife biopsy. Mol Med Rep 12(2):2985–2990CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Obstetrics and GynecologyUniversity of Brescia, Spedali Civili of BresciaBresciaItaly

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