Surgical Endoscopy

, 24:63 | Cite as

Laparoscopic colorectal resection for deep infiltrating endometriosis: analysis of 436 cases

  • Giacomo Ruffo
  • Filippo Scopelliti
  • Marco Scioscia
  • Marcello Ceccaroni
  • Paride Mainardi
  • Luca Minelli



Complete removal of all visible lesions is considered the adequate treatment of pelvic endometriosis in order to reduce recurrence. Laparoscopic colorectal resection of bowel endometriosis is still challenging. A large series is reported.


A longitudinal evaluation of surgical and clinical complications of 436 cases of severe endometriosis with colorectal resection was carried out. All procedures were performed laparoscopically in a single center and short-term complications were surveyed.


The overall complication rate was 8.3% with need for laparoconversion in 3.2%. Sixty patients required blood transfusion (13.7%), and rectovaginal fistulae were the most frequent postoperative complication (3.2%).


Laparoscopic colorectal resection for endometriosis is a relatively safe procedure in a context of close collaboration between gynecologists and surgeons, although it requires adequate training.


Endometriosis Colorectal surgery Bowel endometriosis Laparoscopy 


  1. 1.
    Giudice LC, Kao LC (2004) Endometriosis. Lancet 364:1789–1799CrossRefPubMedGoogle Scholar
  2. 2.
    Darai E, Thomassin I, Barranger E, Detchev R, Cortez A, Houry S, Bazot M (2005) Feasibility and clinical outcome of laparoscopic colorectal resection for endometriosis. Am J Obstet Gynecol 192:394–400CrossRefPubMedGoogle Scholar
  3. 3.
    Dubernard G, Piketty M, Rouzier R, Houry S, Bazot M, Darai E (2006) Quality of life after laparoscopic colorectal resection for endometriosis. Hum Reprod 21:1243–1247CrossRefPubMedGoogle Scholar
  4. 4.
    Fedele L, Bianchi S, Zanconato G, Raffaelli R, Berlanda N (2004) Is rectovaginal endometriosis a progressive disease? Am J Obstet Gynecol 191:1539–1542CrossRefPubMedGoogle Scholar
  5. 5.
    Koh CH, Janik GM (2002) The surgical management of deep rectovaginal endometriosis. Curr Opin Obstet Gynecol 14:357–364CrossRefPubMedGoogle Scholar
  6. 6.
    Vercellini P, Pietropaolo G, De GO, Pasin R, Chiodini A, Crosignani PG (2005) Treatment of symptomatic rectovaginal endometriosis with an estrogen-progestogen combination versus low-dose norethindrone acetate. Fertil Steril 84:1375–1387CrossRefPubMedGoogle Scholar
  7. 7.
    Chapron C, Jacob S, Dubuisson JB, Vieira M, Liaras E, Fauconnier A (2001) Laparoscopically assisted vaginal management of deep endometriosis infiltrating the rectovaginal septum. Acta Obstet Gynecol Scand 80:349–354PubMedGoogle Scholar
  8. 8.
    Garry R, Clayton R, Hawe J (2000) The effect of endometriosis and its radical laparoscopic excision on quality of life indicators. BJOG 107:44–54CrossRefPubMedGoogle Scholar
  9. 9.
    Mereu L, Ruffo G, Landi S, Barbieri F, Zaccoletti R, Fiaccavento A, Stepniewska A, Pontrelli G, Minelli L (2007) Laparoscopic treatment of deep endometriosis with segmental colorectal resection: short-term morbidity. J Minim Invasive Gynecol 14:463–469CrossRefPubMedGoogle Scholar
  10. 10.
    Remorgida V, Ragni N, Ferrero S, Anserini P, Torelli P, Fulcheri E (2005) How complete is full thickness disc resection of bowel endometriotic lesions? A prospective surgical and histological study. Hum Reprod 20:2317–2320CrossRefPubMedGoogle Scholar
  11. 11.
    Redwine DB, Sharpe DR (1991) Laparoscopic segmental resection of the sigmoid colon for endometriosis. J Laparoendosc Surg 1:217–220PubMedGoogle Scholar
  12. 12.
    Nezhat C, Nezhat F, Pennington E (1992) Laparoscopic treatment of infiltrative rectosigmoid colon and rectovaginal septum endometriosis by the technique of videolaparoscopy and the CO2 laser. Br J Obstet Gynaecol 99:664–667PubMedGoogle Scholar
  13. 13.
    Duepree HJ, Senagore AJ, Delaney CP, Marcello PW, Brady KM, Falcone T (2002) Laparoscopic resection of deep pelvic endometriosis with rectosigmoid involvement. J Am Coll Surg 195:754–758CrossRefPubMedGoogle Scholar
  14. 14.
    Jerby BL, Kessler H, Falcone T, Milsom JW (1999) Laparoscopic management of colorectal endometriosis. Surg Endosc 13:1125–1128CrossRefPubMedGoogle Scholar
  15. 15.
    Possover M, Diebolder H, Plaul K, Schneider A (2000) Laparascopically assisted vaginal resection of rectovaginal endometriosis. Obstet Gynecol 96:304–307CrossRefPubMedGoogle Scholar
  16. 16.
    Faccioli N, Manfredi R, Mainardi P, Dalla CE, Spoto E, Minelli L, Mucelli RP (2008) Barium enema evaluation of colonic involvement in endometriosis. AJR Am J Roentgenol 190:1050–1054CrossRefPubMedGoogle Scholar
  17. 17.
    Landi S, Barbieri F, Fiaccavento A, Mainardi P, Ruffo G, Selvaggi L, Syed R, Minelli L (2004) Preoperative double-contrast barium enema in patients with suspected intestinal endometriosis. J Am Assoc Gynecol Laparosc 11:223–228CrossRefPubMedGoogle Scholar
  18. 18.
    Landi S, Ceccaroni M, Perutelli A, Allodi C, Barbieri F, Fiaccavento A, Ruffo G, McVeigh E, Zanolla L, Minelli L (2006) Laparoscopic nerve-sparing complete excision of deep endometriosis: is it feasible? Hum Reprod 21:774–781CrossRefPubMedGoogle Scholar
  19. 19.
    Darai E, Bazot M, Rouzier R, Houry S, Dubernard G (2007) Outcome of laparoscopic colorectal resection for endometriosis. Curr Opin Obstet Gynecol 19:308–313CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Giacomo Ruffo
    • 1
  • Filippo Scopelliti
    • 1
  • Marco Scioscia
    • 2
  • Marcello Ceccaroni
    • 2
  • Paride Mainardi
    • 3
  • Luca Minelli
    • 2
  1. 1.Department of General SurgerySacro Cuore Don Calabria General HospitalNegrar, VeronaItaly
  2. 2.Department of Obstetrics and GynecologySacro Cuore Don Calabria General HospitalNegrar, VeronaItaly
  3. 3.Department of RadiologySacro Cuore Don Calabria General HospitalNegrar, VeronaItaly

Personalised recommendations