Surgical treatment for colorectal endometriosis. A clinical case

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The article describes a clinical case of successful surgical treatment of a patient with deep endometriosis involving the rectum using the Da Vinci Surgical System. The use of the Da Vinci robotic complex allows for increasing the radicalism of the operation by improving visualization and expanding the surgeon’s manual capabilities. This starts to be possible thanks to the technical advantages of this technology, specifically 3D imaging and the use of EndoWrist instruments with artificial wrists and seven degrees of freedom that provide greater precision when manipulating in a minimally invasive environment. Surgical treatment of colorectal endometriosis includes three types of operations — focus shaving, discoid and circular bowel resections with anastomosis. When choosing a treatment strategy, one needs to take into account the clinical course of the disease, the results of conservative treatment and instrumental methods of research (ultrasound, MRI), and the woman’s reproductive plans. The excision of the infiltrate is an effective method of treating patients with colorectal endometriosis in terms of pain relief, improving the quality of life and restoring reproductive function. Performing such operations is optimal in medical institutions with a multidisciplinary approach.

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About the authors

Alla K. Politova

National Medical and Surgical Center named after N.I. Pirogov

ORCID iD: 0000-0002-5924-2616
SPIN-code: 6558-5394

MD, Dr. Sci. (Med.), Assistant Professor

Russian Federation, Moscow

Andrey V. Maksimenkov

National Medical and Surgical Center named after N.I. Pirogov

Author for correspondence.
SPIN-code: 1559-1172

MD, Cand. Sci. (Med.)

Russian Federation, Moscow

Yulia A. Vershinina

National Medical and Surgical Center named after N.I. Pirogov

ORCID iD: 0000-0003-1941-8450
SPIN-code: 3781-4500
Russian Federation, Moscow

Anastasia D. Alexandrova

National Medical and Surgical Center named after N.I. Pirogov

ORCID iD: 0000-0002-2493-863X
Russian Federation, Moscow

Svetlana V. Dudorova

National Medical and Surgical Center named after N.I. Pirogov

ORCID iD: 0000-0002-9265-6431
Russian Federation, Moscow


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Supplementary files

Supplementary Files
1. Fig. 1. Magnetic resonance picture of infiltrative endometriosis involving the rectum

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2. Fig. 2. Magnetic resonance picture of infiltrative endometriosis involving the rectum

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3. Fig. 3. Retrocervical infiltrate involving the rectum and ovaries

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4. Fig. 4. Excision of the endometrioid infiltrate with opening the vaginal lumen

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5. Fig. 5. The isolated infiltrate retains a connection with the rectum

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6. Fig. 6. Excision of the distal rectum

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7. Fig. 7. Dissected distal rectum

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8. Fig. 8. Removal of the proximal part of the mobilized colon into the wound

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9. Fig. 9. Resected endometrioid infiltrate

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10. Fig. 10. Comparison of the rectal stump

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11. Fig. 11. Sigmorectoanastomosis

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12. Fig. 12. Magnetic resonance picture of fluid accumulation in the presacral space

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СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
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от 15.07.2002 г.

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