A multidisciplinary, minimally invasive approach for complicated deep infiltrating endometriosis.
OBJECTIVE
To present a case of complicated deep infiltrating endometriosis managed by a multidisciplinary minimally invasive approach.


METHODS
Case report.


METHODS
Tertiary care university hospital.


METHODS
A 32-year-old woman with deep infiltrating endometriosis involving the rectovaginal septum, the rectum, and the left ureter, complicated by silent left renal function loss.


METHODS
Laparoscopic left nephrectomy, ureterectomy, excision of a left ovarian endometrioma, removal of a large rectovaginal nodule, and segmental bowel resection with minilaparotomic end-to-end anastomosis.


METHODS
Multidisciplinary diagnosis and minimally invasive surgical approach to deep infiltrating endometriosis involving the rectum and the urinary tract.


RESULTS
Collaboration between gynecologists, urologists, and colorectal surgeons enabled a successful management of the case in one surgical intervention providing minor risk of complications, shorter hospital stay, and faster functional recovery.


CONCLUSIONS
Deep infiltrating endometriosis is a global pathology that may involve different structures. A multidisciplinary, minimally invasive approach should be recommended to achieve appropriate disease management.
Seracchioli
Renato
R
Minimally Invasive Gynecological Surgery Unit, Reproductive Medicine Unit, S. Orsola Hospital, University of Bologna, Italy. seracchioli@aosp.bo.it
Manuzzi
Linda
L
Mabrouk
Mohamed
M
Solfrini
Serena
S
Frascà
Clarissa
C
Manferrari
Fabio
F
Pierangeli
Filippo
F
Paradisi
Roberto
R
Venturoli
Stefano
S
D000328:Adult; D000714:Anastomosis, Surgical; D004715:Endometriosis / Q000601:surgery*; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D006869:Hydronephrosis / Q000601:surgery*; D007422:Intestines / Q000601:surgery; D019060:Minimally Invasive Surgical Procedures; D009392:Nephrectomy; D010053:Ovary / Q000601:surgery; D012007:Rectum / Q000601:surgery; D014513:Ureter / Q000601:surgery