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Related Experiment Video

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Shaving for Bowel Endometriosis.

Danny Chou1, Shevy Perera2, George Condous3

  • 1Sydney Women's Endosurgery Centre (Drs. Chou, Cario, Rosen, Choi, Al-Shamari, and Bukhari), Sydney, Australia.

Journal of Minimally Invasive Gynecology
|November 30, 2019
PubMed
Summary

Laparoscopic rectal shaving is a conservative surgical option for deep endometriosis of the rectosigmoid colon. This technique offers lower complication rates and reduced risk of long-term bladder and bowel dysfunction compared to other methods.

Keywords:
Deeply Infiltrating EndometriosisRectal endometriosisRectal endometriotic noduleRectal shaving

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Area of Science:

  • Minimally Invasive Gynecologic Surgery
  • Gastrointestinal Endoscopy
  • Pelvic Anatomy

Background:

  • Deep endometriosis affects 8-12% of patients, frequently involving the rectosigmoid colon.
  • Rectosigmoid deep endometriosis involves the muscularis layer (>5 mm depth).
  • Surgical options include rectal shaving, disc excision, and segmental resection.

Purpose of the Study:

  • To demonstrate laparoscopic shaving for deep rectosigmoid endometriosis.
  • To emphasize the anatomic and technical aspects of the rectal shaving procedure.

Main Methods:

  • Stepwise video demonstration of laparoscopic rectal shaving.
  • Key steps include ovarian suspension, rectal mobilization, lesion shaving, bowel wall integrity check, and muscularis defect repair.

Main Results:

  • Rectal shaving is suitable for lesions <3 cm.
  • The procedure aims to shave lesions from the muscularis layer without entering the bowel lumen.
  • It is associated with lower perioperative complications and long-term dysfunction.

Conclusions:

  • Laparoscopic rectal shaving is a conservative approach for bowel endometriosis.
  • It presents lower complication rates and reduced risk of long-term bladder/bowel dysfunction.
  • Shaving is recommended for appropriate lesions.