Derin İnfiltratif Endometriozis Cerrahisi İçin Güvenli Laparoskopik Cerrahi Teknik
Synopsis
Derin infiltratif endometriozis cerrahisi son derece karmaşık, zor ve komplikasyon ihtimali yüksek cerrahi gruplarından oluşmaktadır. Cerrahi müdahalenin büyüklüğünü ve karmaşıklığını tahmin edebilmek için operasyon öncesi detaylı değerlendirme oldukça önem arz eder. Tüm planlanan veya gerekebilecek cerrahi işlemler hastalar ile ayrıntılı paylaşılmalı ve mutlaka gerekli aydınlatılmış onamlar alınmalıdır. İntraoperatif cerrahi güvenlikten ödün vermemek adına öncelikle tüm anatomik yapıların açıkça belirlenmesi ya da görünür hale gelmesi için çaba gösterilmelidir. Laparoskopik yaklaşım sıklıkla tercih edilmekte ve derin infiltratif endometriozis cerrahisi için güvenli laparoskopinin adımları güncel literatürde tanımlanmıştır. Diğer bir önemli parametre ise gerektiğinde operasyonu genel cerrahi ve üroloji hekimlerinin de olduğu multidisipliner bir ekibin yönetmesi olmalıdır.
Deep infiltrative endometriosis surgery presents a formidable challenge, characterized by its complexity and the high potential for complications. A thorough preoperative evaluation is essential to accurately assess the extent and intricacy of the surgical intervention required. It is imperative that all planned surgical procedures are communicated in detail to patients, ensuring that informed consent is meticulously obtained. To safeguard intraoperative surgical safety, a concerted effort must be made to clearly delineate all anatomical structures. The laparoscopic approach is often preferred for deep infiltrative endometriosis surgery, and the steps for safe laparoscopy have been outlined in current literature. It is also important that the operation be conducted by a multidisciplinary team, which may include general surgeons and urologists when needed.
References
Nisolle M, Donnez J. Peritoneal endometriosis, ovarian endometriosis, and adenomyotic nodules of the rectovaginal septum are three different entities. Fertil Steril. 1997;68(4):585-596.
Dan I Lebovic, MD. Endometriosis: Surgical management of pelvic pain. Tommaso Falcone, MD, FRCSC, FACOG (Ed), Wolters Kluwer. (Accessed on July 28, 2024)
Ong HI, Shulman N, Nugraha P, et al. Role of robot-assisted laparoscopy in deep infiltrating endometriosis with bowel involvement: a systematic review and application of the IDEAL framework. Int J Colorectal Dis. 2024;39(1):98.
Taylor HS, Kotlyar AM, Flores VA. Endometriosis is a chronic systemic disease: clinical challenges and novel innovations. Lancet. 2021;397(10276):839-852.
Chapron C, Marcellin L, Borghese B, et al. Rethinking mechanisms, diagnosis and management of endometriosis. Nat Rev Endocrinol. 2019;15(11):666-682.
Meuleman C, Tomassetti C, D'Hoore A, et al. Surgical treatment of deeply infiltrating endometriosis with colorectal involvement. Hum Reprod Update. 2011;17(3):311-326.
Redwine DB. Diaphragmatic endometriosis: diagnosis, surgical management, and long-term results of treatment. Fertil Steril. 2002;77(2):288-296.
Nisolle M, Brichant G, Tebache L. Choosing the right technique for deep endometriosis. Best Pract Res Clin Obstet Gynaecol. 2019;59:56-65.
Chapron C, Fauconnier A, Vieira M, et al. Anatomical distribution of deeply infiltrating endometriosis: surgical implications and proposition for a classification. Hum Reprod. 2003;18(1):157-161.
Young SW, Dahiya N, Yi J, et al. Impact of Uterine Sliding Sign in Routine United States Ultrasound Practice. J Ultrasound Med. 2021;40(6):1091-1096.
Piessens S, Edwards A. Sonographic Evaluation for Endometriosis in Routine Pelvic Ultrasound. J Minim Invasive Gynecol. 2020;27(2):265-266.
Practice Committee of the American Society for Reproductive Medicine. Treatment of pelvic pain associated with endometriosis: a committee opinion [published correction appears in Fertil Steril. 2015 Aug;104(2):498]. Fertil Steril. 2014;101(4):927-935.
Becker CM, Bokor A, Heikinheimo O, et al. ESHRE guideline: endometriosis. Hum Reprod Open. 2022;2022(2):hoac009.
Chapron C, Fauconnier A, Goffinet F, et al. Laparoscopic surgery is not inherently dangerous for patients presenting with benign gynaecologic pathology. Results of a meta-analysis. Hum Reprod. 2002;17(5):1334-1342.
Crosignani PG, Vercellini P, Biffignandi F, Costantini W, Cortesi I, Imparato E. Laparoscopy versus laparotomy in conservative surgical treatment for severe endometriosis. Fertil Steril. 1996;66(5):706-711.
Pascoal E, Wessels JM, Aas-Eng MK, et al. Strengths and limitations of diagnostic tools for endometriosis and relevance in diagnostic test accuracy research. Ultrasound Obstet Gynecol. 2022;60(3):309-327.
Casarin J, Cromi A, Bogani G, Multinu F, Uccella S, Ghezzi F. Surgical morbidity of total laparoscopic hysterectomy for benign disease: Predictors of major postoperative complications. Eur J Obstet Gynecol Reprod Biol. 2021;263:210-215.
Chapron C, Querleu D, Bruhat MA, et al. Surgical complications of diagnostic and operative gynaecological laparoscopy: a series of 29,966 cases. Hum Reprod. 1998;13(4):867-872.
Fauconnier A, Chapron C. Endometriosis and pelvic pain: epidemiological evidence of the relationship and implications. Hum Reprod Update. 2005;11(6):595-606.
Daraï E, Cohen J, Ballester M. Colorectal endometriosis and fertility. Eur J Obstet Gynecol Reprod Biol. 2017;209:86-94.
Wills HJ, Reid GD, Cooper MJ, et al. Fertility and pain outcomes following laparoscopic segmental bowel resection for colorectal endometriosis: a review. Aust N Z J Obstet Gynaecol. 2008;48(3):292-295.
Bazot M, Lafont C, Rouzier R, et al. Diagnostic accuracy of physical examination, transvaginal sonography, rectal endoscopic sonography, and magnetic resonance imaging to diagnose deep infiltrating endometriosis. Fertil Steril. 2009;92(6):1825-1833.
Roman H, Vassilieff M, Tuech JJ, et al. Postoperative digestive function after radical versus conservative surgical philosophy for deep endometriosis infiltrating the rectum. Fertil Steril. 2013;99(6):1695-1704.
Roman H, Milles M, Vassilieff M, et al. Long-term functional outcomes following colorectal resection versus shaving for rectal endometriosis. Am J Obstet Gynecol. 2016;215(6):762.e1-762.e9.
Donnez O, Roman H. Choosing the right surgical technique for deep endometriosis: shaving, disc excision, or bowel resection?. Fertil Steril. 2017;108(6):931-942.
Reich H, McGlynn F, Salvat J. Laparoscopic treatment of cul-de-sac obliteration secondary to retrocervical deep fibrotic endometriosis. J Reprod Med. 1991;36(7):516-522.
Donnez J, Nisolle M, Casanas-Roux F, et al. Rectovaginal septum, endometriosis or adenomyosis: laparoscopic management in a series of 231 patients. Hum Reprod. 1995;10(3):630-635.
Roman H. Rectal shaving using PlasmaJet in deep endometriosis of the rectum. Fertil Steril. 2013;100(5):e33.
Kondo W, Bourdel N, Jardon K, et al. Comparison between standard and reverse laparoscopic techniques for rectovaginal endometriosis. Surg Endosc. 2011;25(8):2711-2717.
Abrão MS, Podgaec S, Dias JA Jr, et al. Endometriosis lesions that compromise the rectum deeper than the inner muscularis layer have more than 40% of the circumference of the rectum affected by the disease. J Minim Invasive Gynecol. 2008;15(3):280-285.
Raimondo D, Ianieri MM, Raffone A, et al. Feasibility of Intraoperative Proctosigmoidoscopy After Discoid Bowel Resection for Deep Infiltrating Endometriosis: A Pilot Multicenter Study. J Minim Invasive Gynecol. 2024;31(8):680-687.
Ricciardi R, Roberts PL, Marcello PW, et al. Anastomotic leak testing after colorectal resection: what are the data?. Arch Surg. 2009;144(5):407-412.
Roman H; FRIENDS group (French coloRectal Infiltrating ENDometriosis Study group). A national snapshot of the surgical management of deep infiltrating endometriosis of the rectum and colon in France in 2015: A multicenter series of 1135 cases. J Gynecol Obstet Hum Reprod. 2017;46(2):159-165.
Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240(2):205-213.
Byrne D, Curnow T, Smith P, et al. Laparoscopic excision of deep rectovaginal endometriosis in BSGE endometriosis centres: a multicentre prospective cohort study. BMJ Open. 2018;8(4):e018924.
Roman H, Darwish B, Bridoux V, et al. Functional outcomes after disc excision in deep endometriosis of the rectum using transanal staplers: a series of 111 consecutive patients. Fertil Steril. 2017;107(4):977-986.e2.
Dousset B, Leconte M, Borghese B, et al. Complete surgery for low rectal endometriosis: long-term results of a 100-case prospective study. Ann Surg. 2010;251(5):887-895.
Ruffo G, Sartori A, Crippa S, et al. Laparoscopic rectal resection for severe endometriosis of the mid and low rectum: technique and operative results. Surg Endosc. 2012;26(4):1035-1040.
Oliveira MA, Pereira TR, Gilbert A, et al. Bowel complications in endometriosis surgery. Best Pract Res Clin Obstet Gynaecol. 2016;35:51-62.
Vallicelli C, Pirrera B, Alagna V, et al. Intraoperative endoscopy with immediate suture reinforcement of the defect in colorectal anastomosis: a pilot study. Updates Surg. 2020;72(4):999-1004.
Farzaneh C, Duong WQ, Stopenski S, et al. Intraoperative Anastomotic Evaluation Methods: Rigid Proctoscopy Versus Flexible Endoscopy. J Surg Res. 2023;290:45-51.
Malzoni M, Coppola M, Casarella L, et al. Laparoscopic Double Discoid Colorectal Resection for the Treatment of Two Distinct Deep Endometriotic Nodules. J Minim Invasive Gynecol. 2023;30(12):946-947.
Malzoni M, Casarella L, Coppola M, et al. Preoperative Ultrasound Indications Determine Excision Technique for Bowel Surgery for Deep Infiltrating Endometriosis: A Single, High-Volume Center. J Minim Invasive Gynecol. 2020;27(5):1141-1147.
Kondo W, Bourdel N, Tamburro S, et al. Complications after surgery for deeply infiltrating pelvic endometriosis. BJOG. 2011;118(3):292-298.
Carmona F, Martínez-Zamora A, González X, et al. Does the learning curve of conservative laparoscopic surgery in women with rectovaginal endometriosis impair the recurrence rate?. Fertil Steril. 2009;92(3):868-875.
Yoshida K, Kato T, Kinochi R, et al. Evaluation of Deeply Infiltrating Endometriosis by Preoperative Magnetic Resonance Imaging in Patients with Adenomyosis. Gynecol Minim Invasive Ther. 2023;13(2):105-110.
Ota K, Sato K, Tanaka M. Ureteral stenosis due to DIE (deep infiltrating endometriosis) with difficulty in treatment: Case report and brief literature review. Gynecol Minim Invasive Ther. 2017;6(4):214-216.
Htut HT, Liu HM, Lee CL. Laparoscopic Excision of Severe Deep Infiltrating Endometriosis. Gynecol Minim Invasive Ther. 2022;11(1):76-77.
Buttignol M, Faller E, Lecointre L, et al. Deep infiltrating endometriosis: Laparoscopic nerve-sparing surgery and use of neutral argon plasma. J Gynecol Obstet Hum Reprod. 2023;52(5):102573.
Hardman D, Bennett R, Mikhail E. Laparoscopic shaving of rectosigmoid deep infiltrating endometriosis under laparoscopic ultrasound guidance. Fertil Steril. 2023;120(1):206-207.
Barra F, Zorzi C, Albanese M, et al. Ultrasonographic characterization of parametrial endometriosis: a prospective study. Fertil Steril. 2024;122(1):150-161.
Dan I Lebovic, MD. Endometriosis: Surgical management of pelvic pain. Tommaso Falcone, MD, FRCSC, FACOG (Ed), Wolters Kluwer. (Accessed on July 28, 2024)
Ong HI, Shulman N, Nugraha P, et al. Role of robot-assisted laparoscopy in deep infiltrating endometriosis with bowel involvement: a systematic review and application of the IDEAL framework. Int J Colorectal Dis. 2024;39(1):98.
Taylor HS, Kotlyar AM, Flores VA. Endometriosis is a chronic systemic disease: clinical challenges and novel innovations. Lancet. 2021;397(10276):839-852.
Chapron C, Marcellin L, Borghese B, et al. Rethinking mechanisms, diagnosis and management of endometriosis. Nat Rev Endocrinol. 2019;15(11):666-682.
Meuleman C, Tomassetti C, D'Hoore A, et al. Surgical treatment of deeply infiltrating endometriosis with colorectal involvement. Hum Reprod Update. 2011;17(3):311-326.
Redwine DB. Diaphragmatic endometriosis: diagnosis, surgical management, and long-term results of treatment. Fertil Steril. 2002;77(2):288-296.
Nisolle M, Brichant G, Tebache L. Choosing the right technique for deep endometriosis. Best Pract Res Clin Obstet Gynaecol. 2019;59:56-65.
Chapron C, Fauconnier A, Vieira M, et al. Anatomical distribution of deeply infiltrating endometriosis: surgical implications and proposition for a classification. Hum Reprod. 2003;18(1):157-161.
Young SW, Dahiya N, Yi J, et al. Impact of Uterine Sliding Sign in Routine United States Ultrasound Practice. J Ultrasound Med. 2021;40(6):1091-1096.
Piessens S, Edwards A. Sonographic Evaluation for Endometriosis in Routine Pelvic Ultrasound. J Minim Invasive Gynecol. 2020;27(2):265-266.
Practice Committee of the American Society for Reproductive Medicine. Treatment of pelvic pain associated with endometriosis: a committee opinion [published correction appears in Fertil Steril. 2015 Aug;104(2):498]. Fertil Steril. 2014;101(4):927-935.
Becker CM, Bokor A, Heikinheimo O, et al. ESHRE guideline: endometriosis. Hum Reprod Open. 2022;2022(2):hoac009.
Chapron C, Fauconnier A, Goffinet F, et al. Laparoscopic surgery is not inherently dangerous for patients presenting with benign gynaecologic pathology. Results of a meta-analysis. Hum Reprod. 2002;17(5):1334-1342.
Crosignani PG, Vercellini P, Biffignandi F, Costantini W, Cortesi I, Imparato E. Laparoscopy versus laparotomy in conservative surgical treatment for severe endometriosis. Fertil Steril. 1996;66(5):706-711.
Pascoal E, Wessels JM, Aas-Eng MK, et al. Strengths and limitations of diagnostic tools for endometriosis and relevance in diagnostic test accuracy research. Ultrasound Obstet Gynecol. 2022;60(3):309-327.
Casarin J, Cromi A, Bogani G, Multinu F, Uccella S, Ghezzi F. Surgical morbidity of total laparoscopic hysterectomy for benign disease: Predictors of major postoperative complications. Eur J Obstet Gynecol Reprod Biol. 2021;263:210-215.
Chapron C, Querleu D, Bruhat MA, et al. Surgical complications of diagnostic and operative gynaecological laparoscopy: a series of 29,966 cases. Hum Reprod. 1998;13(4):867-872.
Fauconnier A, Chapron C. Endometriosis and pelvic pain: epidemiological evidence of the relationship and implications. Hum Reprod Update. 2005;11(6):595-606.
Daraï E, Cohen J, Ballester M. Colorectal endometriosis and fertility. Eur J Obstet Gynecol Reprod Biol. 2017;209:86-94.
Wills HJ, Reid GD, Cooper MJ, et al. Fertility and pain outcomes following laparoscopic segmental bowel resection for colorectal endometriosis: a review. Aust N Z J Obstet Gynaecol. 2008;48(3):292-295.
Bazot M, Lafont C, Rouzier R, et al. Diagnostic accuracy of physical examination, transvaginal sonography, rectal endoscopic sonography, and magnetic resonance imaging to diagnose deep infiltrating endometriosis. Fertil Steril. 2009;92(6):1825-1833.
Roman H, Vassilieff M, Tuech JJ, et al. Postoperative digestive function after radical versus conservative surgical philosophy for deep endometriosis infiltrating the rectum. Fertil Steril. 2013;99(6):1695-1704.
Roman H, Milles M, Vassilieff M, et al. Long-term functional outcomes following colorectal resection versus shaving for rectal endometriosis. Am J Obstet Gynecol. 2016;215(6):762.e1-762.e9.
Donnez O, Roman H. Choosing the right surgical technique for deep endometriosis: shaving, disc excision, or bowel resection?. Fertil Steril. 2017;108(6):931-942.
Reich H, McGlynn F, Salvat J. Laparoscopic treatment of cul-de-sac obliteration secondary to retrocervical deep fibrotic endometriosis. J Reprod Med. 1991;36(7):516-522.
Donnez J, Nisolle M, Casanas-Roux F, et al. Rectovaginal septum, endometriosis or adenomyosis: laparoscopic management in a series of 231 patients. Hum Reprod. 1995;10(3):630-635.
Roman H. Rectal shaving using PlasmaJet in deep endometriosis of the rectum. Fertil Steril. 2013;100(5):e33.
Kondo W, Bourdel N, Jardon K, et al. Comparison between standard and reverse laparoscopic techniques for rectovaginal endometriosis. Surg Endosc. 2011;25(8):2711-2717.
Abrão MS, Podgaec S, Dias JA Jr, et al. Endometriosis lesions that compromise the rectum deeper than the inner muscularis layer have more than 40% of the circumference of the rectum affected by the disease. J Minim Invasive Gynecol. 2008;15(3):280-285.
Raimondo D, Ianieri MM, Raffone A, et al. Feasibility of Intraoperative Proctosigmoidoscopy After Discoid Bowel Resection for Deep Infiltrating Endometriosis: A Pilot Multicenter Study. J Minim Invasive Gynecol. 2024;31(8):680-687.
Ricciardi R, Roberts PL, Marcello PW, et al. Anastomotic leak testing after colorectal resection: what are the data?. Arch Surg. 2009;144(5):407-412.
Roman H; FRIENDS group (French coloRectal Infiltrating ENDometriosis Study group). A national snapshot of the surgical management of deep infiltrating endometriosis of the rectum and colon in France in 2015: A multicenter series of 1135 cases. J Gynecol Obstet Hum Reprod. 2017;46(2):159-165.
Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240(2):205-213.
Byrne D, Curnow T, Smith P, et al. Laparoscopic excision of deep rectovaginal endometriosis in BSGE endometriosis centres: a multicentre prospective cohort study. BMJ Open. 2018;8(4):e018924.
Roman H, Darwish B, Bridoux V, et al. Functional outcomes after disc excision in deep endometriosis of the rectum using transanal staplers: a series of 111 consecutive patients. Fertil Steril. 2017;107(4):977-986.e2.
Dousset B, Leconte M, Borghese B, et al. Complete surgery for low rectal endometriosis: long-term results of a 100-case prospective study. Ann Surg. 2010;251(5):887-895.
Ruffo G, Sartori A, Crippa S, et al. Laparoscopic rectal resection for severe endometriosis of the mid and low rectum: technique and operative results. Surg Endosc. 2012;26(4):1035-1040.
Oliveira MA, Pereira TR, Gilbert A, et al. Bowel complications in endometriosis surgery. Best Pract Res Clin Obstet Gynaecol. 2016;35:51-62.
Vallicelli C, Pirrera B, Alagna V, et al. Intraoperative endoscopy with immediate suture reinforcement of the defect in colorectal anastomosis: a pilot study. Updates Surg. 2020;72(4):999-1004.
Farzaneh C, Duong WQ, Stopenski S, et al. Intraoperative Anastomotic Evaluation Methods: Rigid Proctoscopy Versus Flexible Endoscopy. J Surg Res. 2023;290:45-51.
Malzoni M, Coppola M, Casarella L, et al. Laparoscopic Double Discoid Colorectal Resection for the Treatment of Two Distinct Deep Endometriotic Nodules. J Minim Invasive Gynecol. 2023;30(12):946-947.
Malzoni M, Casarella L, Coppola M, et al. Preoperative Ultrasound Indications Determine Excision Technique for Bowel Surgery for Deep Infiltrating Endometriosis: A Single, High-Volume Center. J Minim Invasive Gynecol. 2020;27(5):1141-1147.
Kondo W, Bourdel N, Tamburro S, et al. Complications after surgery for deeply infiltrating pelvic endometriosis. BJOG. 2011;118(3):292-298.
Carmona F, Martínez-Zamora A, González X, et al. Does the learning curve of conservative laparoscopic surgery in women with rectovaginal endometriosis impair the recurrence rate?. Fertil Steril. 2009;92(3):868-875.
Yoshida K, Kato T, Kinochi R, et al. Evaluation of Deeply Infiltrating Endometriosis by Preoperative Magnetic Resonance Imaging in Patients with Adenomyosis. Gynecol Minim Invasive Ther. 2023;13(2):105-110.
Ota K, Sato K, Tanaka M. Ureteral stenosis due to DIE (deep infiltrating endometriosis) with difficulty in treatment: Case report and brief literature review. Gynecol Minim Invasive Ther. 2017;6(4):214-216.
Htut HT, Liu HM, Lee CL. Laparoscopic Excision of Severe Deep Infiltrating Endometriosis. Gynecol Minim Invasive Ther. 2022;11(1):76-77.
Buttignol M, Faller E, Lecointre L, et al. Deep infiltrating endometriosis: Laparoscopic nerve-sparing surgery and use of neutral argon plasma. J Gynecol Obstet Hum Reprod. 2023;52(5):102573.
Hardman D, Bennett R, Mikhail E. Laparoscopic shaving of rectosigmoid deep infiltrating endometriosis under laparoscopic ultrasound guidance. Fertil Steril. 2023;120(1):206-207.
Barra F, Zorzi C, Albanese M, et al. Ultrasonographic characterization of parametrial endometriosis: a prospective study. Fertil Steril. 2024;122(1):150-161.
Pages
307-312
Published
January 21, 2025
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