Colectomy for endometriosis with natural orifice specimen extraction technique in 10 steps – a video vignette

Grigoriadis, Georgios; Merlot, Benjamin; Dennis, Thomas; Roman, Horace

doi:10.1111/codi.16340

Cited by 1 publication

(2 citation statements)

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“…The NOSE technique has been applied since 2021 and was used in 13 out of 97 cases in the robotic-assisted approach group as an alternative to conventional minilaparotomy to extract the specimen after the colorectal resection. In our analysis, the NOSE technique was not associated with an increased risk of anastomosis complications (Table S1), which is consistent with previous studies [20,21]. Due to the progressive reduction in the utilization of the preventive stoma in the IFEM Endo since 2018, we were not able to evaluate stoma complications.…”

Section: Discussionsupporting

confidence: 88%

“…Disc excisions were routinely performed using an end-to-end anastomosis circular stapler [16,17]. Colorectal segmental resection was carried out with specimen extraction through a 3-4 cm suprapubic incision or using the natural orifice specimen extraction (NOSE) technique [20,21]. The suture of the vagina was performed using separate Vicryl 0 (Ethicon Inc.) stitches or a running 3-0 V-loc (Medtronic) suture.…”

Section: Interventionsmentioning

confidence: 99%

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Robotic‐assisted versus conventional laparoscopic approach in patients with large rectal endometriotic nodule: the evaluation of safety and complications

Volodarsky‐Perel,

Merlot,

Denost

et al. 2023

Colorectal Disease

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AimThe aim was to compare postoperative complications in patients undergoing the excision of a rectal endometriotic nodule over 3 cm by a robotic‐assisted versus a conventional laparoscopic approach.MethodsWe conducted a retrospective cohort study evaluating prospectively collected data. The main interventions included rectal shaving, disc excision or colorectal resection. All the surgeries were performed in one endometriosis reference institute. To evaluate factors significantly associated with the risk of anastomosis leakage or fistula and bladder atony, we conducted a multivariate logistic regression model.ResultsA total of 548 patients with rectal endometriotic nodule over 3 cm in diameter (#ENZIAN C3) were included in the final analysis. The demography and clinical characteristics of women managed by the robotic‐assisted (n = 97) approach were similar to those of patients who underwent conventional laparoscopy (n = 451). The multivariate logistic regression demonstrated that the surgical approach (robotic‐assisted vs. laparoscopic) was not associated with the rate of anastomosis leakage or fistula (adjusted odds ratio [aOR] 1.2, 95% confidence interval [CI] 0.3–4.0) and bladder dysfunction (aOR 0.5, 95% CI 0.1–1.8). A rectal nodule located lower than 6 cm from the anal verge was significantly associated with anastomosis leakage (aOR 4.1, 95% CI 1.4–10.8) and bladder atony (aOR 4.3, 95% CI 1.5–12.3). Anastomosis leakage was also associated with smoking (aOR 3.2, 95% CI 1.4–7.4), significant vaginal infiltration (aOR 2.7, 95% CI 1.2–6.7) and excision of nodules involving sacral roots (aOR 5.6, 95% CI 1.7–15.5).ConclusionThe robotic‐assisted approach was not associated with increased risk of main postoperative complications compared to conventional laparoscopy for the treatment of large rectal endometriotic nodules.

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Section: Discussionsupporting

confidence: 88%