Bowel endometriosis: Surgical customization is demanding

Best Pract Res Clin Obstet Gynaecol. 2024 Jun:94:102495. doi: 10.1016/j.bpobgyn.2024.102495. Epub 2024 Mar 31.

Abstract

Bowel endometriosis is the most common form of severe deep endometriosis. Surgery is an option in case of infertility and/or chronic pain or in the presence of a stenotic lesion. Clinical examination and preoperative imaging must provide an identity card of the lesion so that customized surgery can be proposed. The primary objective of this tailor-made surgery will always be to preserve the organ. The surgeon then has three options: shaving, discoid resection and segmental resection. The more extensive the resection, the greater the risk of severe short- and long-term complications. Surgery must therefore be adapted to the patient's specific situation and needs. Moreover, personalized care must extend beyond surgery. It must begin before the operation, preparing the patient for the operation like an athlete before a race, and continue afterwards by adapting the follow-up to the surgery performed.

Keywords: Bowel endometriosis; Colorectal shaving; Disc excision; Early rehabilitation protocol; Segmental resection.

Publication types

  • Review

MeSH terms

  • Endometriosis* / surgery
  • Female
  • Humans
  • Infertility, Female / etiology
  • Infertility, Female / surgery
  • Intestinal Diseases / surgery
  • Laparoscopy / methods