Application of NOSE technique for laparoscopic large bowel resection in patients with infiltrating endometriosis

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Resumo

Laparoscopic surgery for colorectal endometriosis is used due to necessity for large bowel resection and application of сircular stapling anastomosis. Natural Orifice Specimen Extraction (NOSE) is a technique that makes it possible to perform step-by step procedures for intestinal fragments extraction and installation of extraction device without using minilaparotomy. NOSE surgery is less painful and provides a cosmetic effect without worsening treatment results.

Objective: To assess the effectiveness and safety of NOSE technique for laparoscopic large bowel resection in patients with colorectal endometriosis.

Materials and methods: The study was carried out from 2023 to 2025 at the Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia. A total of 15 patients who underwent NOSE surgery, and 45 patients who underwent bowel resection using minilaparotomy were examined. The duration of surgery, blood loss, postoperative pain (according visual analog scale (VAS) scores), the length of hospital stay, and treatment outcomes were assessed.

Results: The duration of surgery, the length of hospital stay in the studied groups of patients were almost similar. Also, there were no differences in treatment outcomes. Pain intensity in the group of women who underwent NOSE surgery was significantly lower on the third day after surgery.

Conclusion: The use of NOSE technique for laparoscopic large bowel resection in patients with colorectal endometriosis makes it possible to achieve the effectiveness and safety comparable with conventional surgical approach. Moreover, there was reduction of postoperative pain and better cosmetic effect after surgery.

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Sobre autores

Dmitry Ovodenko

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: d_ovodenko@oparina4.ru
ORCID ID: 0000-0003-0700-8374

Dr. Med. Sci., Head of the Department of Innovative Oncology and Gynecology

Rússia, 4 Ac. Oparin str., Moscow, 117997

Fedor Cheknizov

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Autor responsável pela correspondência
Email: fedo7700@mail.ru
ORCID ID: 0009-0005-1748-7630

2nd year clinical resident, Department of Obstetrics and Gynecology, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

Rússia, 4 Ac. Oparin str., Moscow, 117997

Muslim Maltsagov

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: terekman94@gmail.com

oncologist-gynecologist, Department of Innovative Oncology and Gynecology

Rússia, 4 Ac. Oparin str., Moscow, 117997

Vladimir Chuprynin

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: v_chuprynin@oparina4.ru
ORCID ID: 0009-0003-7856-2863

PhD, Head of the Surgical Department

Rússia, 4 Ac. Oparin str., Moscow, 117997

Bibliografia

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2. Fig. 1. Removal of the intestine through an extended access in the left iliac region

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3. Fig. 2. Fixation of the anvil of the circular stapler in the proximal part of the intestine

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4. Fig. 3. Intersection of the proximal edge of colon resection using the NOSE technique

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5. Fig. 4. Intersection of the distal edge of colon resection using the NOSE technique

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6. Fig. 5. Removal of the resected intestine specimen through the rectum

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7. Fig. 6. Installation of the anvil of the circular stapler into the proximal part of the intestine

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8. Fig. 7. Removing the tip of the anvil of the circular suturing device

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9. Fig. 8. View of postoperative sutures after bowel resection using the NOSE method

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10. Fig. 9. View of postoperative sutures after bowel resection using the traditional method

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