Authors

R. M. Neme; V. Schraibman; S. Okazaki; G. Maccapani; W. J. Chen; C. D. Domit; O. G. Kaufmann;A. P. Advincula

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Abbreviated Journal Title

JSLS-J. Soc. Laparoendosc. Surg.

Keywords

Endometriosis; Rectum; Robotics; Segmental resection; Bowel; endometriosis; BOWEL ENDOMETRIOSIS; MANAGEMENT; RESECTION; EXCISION; GYNECOLOGY; SURGERY; DISEASE; BLADDER; Surgery

Abstract

Background and Objective: Deep infiltrating pelvic endometriosis with bowel involvement is one of the most aggressive forms of endometriosis. Nowadays, robotic technology and telemanipulation systems represent the latest developments in minimally invasive surgery. The aim of this study is to present our preliminary results and evaluate the feasibility of robotic-assisted laparoscopic colorectal resection for severe endometriosis. Methods: Between September 2009 and December 2011, 10 women with colorectal endometriosis underwent surgery with the da Vinci robotic surgical system (Intuitive Surgical, Sunnyvale, CA, USA). We evaluated the following parameters: short-term complications, clinical outcomes and long-term follow-up, pain relief recurrence rate, and fertility outcomes. Results: Extensive ureterolysis was required in 8 women (80%). Ovarian cystectomy with removal of the cystic wall was performed in 7 women (70%). Torus resection was performed in all women, with unilateral and bilateral uterosacral ligament resection in 1 woman (10%) and 8 women (80%), respectively. In addition to segmental colorectal resection in all cases, partial vaginal resection was necessary in 2 women (20%). An appendectomy was performed in 2 patients (20%). The mean operative time with the robot was 157 minutes (range, 90-190 minutes). The mean hospital stay was 3 days. Six patients had infertility before surgery, with a mean infertility time of 2 years. After a 12-month follow-up period, 4 women (67%) conceived naturally and 2 (33%) underwent in vitro fertilization. Conclusion: We show that robotic-assisted laparoscopic surgery for the treatment of deep infiltrating bowel endometriosis is feasible, effective, and safe.

Journal Title

Jsls-Journal of the Society of Laparoendoscopic Surgeons

Volume

17

Issue/Number

2

Publication Date

1-1-2013

Document Type

Article

Language

English

First Page

227

Last Page

234

WOS Identifier

WOS:000323045800010

ISSN

1086-8089

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