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Robot-assisted surgery for the radical treatment of deep infiltrating endometriosis with colorectal involvement: short- and mid-term surgical and functional outcomes

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

Sexual and urinary dysfunctions are complications in radical treatment of deep infiltrating endometriosis (DIE) with colorectal involvement. The aim of this article is to report the preliminary results of our single-institution experience with robotic treatment of DIE, evaluating intraoperative and postoperative surgical outcomes and focusing on the impact of this surgical approach on autonomic functions such as urogenital preservation and sexual well-being.

Methods

From January 2011 through December 2013, a case series of 10 patients underwent robotic radical treatment of DIE with colorectal resection using the da Vinci System. Surgical data were evaluated, together with perioperative urinary and sexual function as assessed by means of self-administered validated questionnaires.

Results

None of the patients reported significant postoperative complications. Questionnaires concerning sexual well-being, urinary function, and impact of symptoms on quality of life demonstrated a slight worsening of all parameters 1 month after surgery, while data were comparable to the preoperative period 1 year after surgery. Dyspareunia was the only exception, as it was significantly improved 12 months after surgery.

Conclusions

Robot-assisted surgery seems to be advantageous in highly complicated procedures where extensive dissection and proper anatomy re-establishment is required, as in DIE with colorectal involvement. Our preliminary results show that robot-assisted surgery could be associated with a low risk of complications and provide good preservation of urinary function and sexual well-being.

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Acknowledgments

Study supported by ARPA foundation, www.fondazionearpa.it.

Author contributions

Study concept and design was done by Morelli, Perutelli, Cela, Guadagni, Di Franco, Palmeri, Mariniello, Di Candio, Salerno and Mosca. Acquisition of data was performed by Morelli, Guadagni, Palmeri, Di Franco, and Mariniello. Analysis and interpretation of data was performed by Morelli, Perutelli, Cela, Salerno Di Candio, and Mosca. Drafting of the manuscript was achieved by Morelli, Guadagni, Brundu and Di Franco. Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved was done by Morelli, Di Candio, Salerno and Mosca. Final approval of the version to be published was done by Di Candio, Salerno and Mosca.

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Authors and Affiliations

  1. General Surgery Unit, Department of Oncology Transplantation and New Technologies, University of Pisa, Via Paradisa 2, 56124, Pisa, Italy

    Luca Morelli, Matteo Palmeri, Simone Guadagni, Maria Donatella Mariniello, Gregorio Di Franco & Giulio Di Candio

  2. EndoCAS (Center of Computer Assisted Surgery), University of Pisa, Pisa, Italy

    Luca Morelli & Franco Mosca

  3. 2nd Department of Obstetrics and Gynecology, Santa Chiara Hospital, Pisa, Italy

    Alessandra Perutelli & Maria Giovanna Salerno

  4. Division of Gynecology and Obstetrics, University of Pisa, Pisa, Italy

    Vito Cela

  5. Obstetrics and Gynecology Unit, Department of Fetal-Maternal Medicine, “G. da Saliceto” Hospital, Piacenza, Italy

    Benedetta Brundu

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  1. Luca Morelli
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  2. Alessandra Perutelli
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Correspondence to Matteo Palmeri.

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The authors declare that they have no competing interests.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Morelli, L., Perutelli, A., Palmeri, M. et al. Robot-assisted surgery for the radical treatment of deep infiltrating endometriosis with colorectal involvement: short- and mid-term surgical and functional outcomes. Int J Colorectal Dis 31, 643–652 (2016). https://doi.org/10.1007/s00384-015-2477-2

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