Laparoscopic colorectal resections with transvaginal specimen extraction for severe endometriosis

Introduction: Bowel resection is now considered the "gold standard" treatment for severe endometriosis infiltrating the bowel. Laparoscopic colorectal resection can be considered a safe option in order to reduce surgical trauma and complications as well as to improve cosmetics. Transvaginal approach, used for several years to remove large specimens, can be an interesting approach also in case of colorectal resections. Aim of the study: To present our experience on laparoscopic colorectal resection and transvaginal specimen extraction as treatment of severe endometriosis. Results: Eleven patients (mean age 45±12 years) have been operated by a combined team of gynecologist and colorectal surgeons. There were no intra- or post-operative complications. In all cases, the transvaginal route was used to remove the specimen and prepare the bowel for anastomosis. Patients were allowed to free light diet on post-operative day 3±1 and discharged on day 5±2. The mean follow-up was 4±2 months and all patients are well with normal bowel function and symptoms free. Conclusions: Our preliminary experience demonstrates such approach is safe and feasible with excellent results in term of post-operative course.