Full laparoscopic sigmoid resection reduced operating times and decreased post-operative VAS-scores and analgesic requirements compared with the conventional laparoscopic sigmoid resection for bowel endometriosis.

Which essential items should be recorded before, during and after endometriosis surgery and in clinical outcome based surgical trials in patients with deep endometriosis (DE)? summary answer: A DE surgical sheet (DESS) was developed for standardized reporting of the surgical treatment of DE and an international expert consensus proposal on relevant items that should be recorded in surgical outcome trials in women with DE. what is known already: Surgery is an important treatment for symptomatic DE. So far, data have been reported in such a way that comparison of different surgical techniques is impossible. Therefore, we present an international expert proposal for standardized reporting of surgical treatment and surgical outcome trials in women with DE. study design, size, duration: International expert consensus based on a systematic review of literature.

Transanal minimally invasive surgery (TAMIS) is typically used for treating intraluminal rectal tumors. Other applications have recently been described. We here present the use of TAMIS as a tool to treat a chronic anastomotic fistula after restorative rectal resection. A new insufflation device expected to solve the problem of maintaining a stable pneumorectum is described.

Background There is an ongoing debate whether the type of anastomosis following intestinal resection for Crohn’s disease (CD) can have an impact on complications and postoperative recurrence. The aim of the present study is to describe the outcome of side-to-side (S-S) versus end-to-end (E-E) anastomosis after ileocolic resection for CD. Methods A retrospective single center comparative study was conducted in consecutive CD patients who underwent primary ileocecal resection between 2005 and 2013. All patients underwent colonoscopy 6-months postoperatively to assess endoscopic recurrence, defined as modified Rutgeerts’ score >i2b. Surgical recurrence implied reoperation due to CD activity at the anastomotic site. Modified surgical recurrences was defined as the need for re-operation or balloon-dilation. Perioperative factors related to recurrence were evaluated. Results Of the128 patients included, 52 (40.6%) received an E-E anastomosis. Median follow-up was longer in the E-E group (8.62 vs 13.68 years, p<0.001). Apart from the primary anastomosis, patient, disease and surgical characteristics were similar between both groups. Postoperative complications and anastomotic leak were comparable (S-S 6.6% vs E-E 7.7%, p=1.00). During the entire postoperative follow-up, biologicals were used in 55.3% and 63.5% (p=0.37) in S-S and E-E patients, respectively. Endoscopic recurrence did not differ between S-S and E-E patients (40.8% vs 49.0%, p=0.37). However, at ten years follow-up, surgical and modified surgical recurrence rate were significantly higher in the E-E group (19.7% vs 7.4%, p=0.02 and 39.2% vs 14.1%, p=0.001). Type of anastomosis was the only independent risk factor for surgical and modified surgical recurrence. Conclusion The type of anastomosis did not influence endoscopic recurrence and immediate postoperative disease complications. However, the wide diameter and the morphologic characteristic of the stapled S-S anastomosis result in a lower risk for balloon dilatation and surgical reintervention in the long-term.

Laparoscopic NOSE colectomy with a camera sleeve is feasible, but it remains to be shown that this technical modification will lead to an increase in indications for left-sided colonic resections.