title: A new technique of laparoscopic intracorporeal anastomosis for transrectal bowel resection with transvaginal specimen extraction.
abstract: OBJECTIVE
  To show a new technique of laparoscopic intracorporeal anastomosis for transrectal bowel resection with transvaginal specimen extraction, a technique particularly suited for treatment of bowel endometriosis.
  
  
  METHODS
  Step-by-step explanation of the technique using videos and pictures (educative video).
  
  
  METHODS
  Endometriosis may affect the bowel in 3% to 37% of all endometriosis cases. Bowel endometriosis affects young women, without any co-morbidities and in particular without any vascular disorders. In addition, affected patients often express a desire for childbearing. Radical excision is sometimes required because of the impossibility of conservative treatment such as shaving, mucosal skinning, or discoid resection. Bowel endometriosis should not be considered a cancer, and consequently maximal resection is not the objective. Rather, the goal would be to achieve functional benefit. As a result, resection must be as economic and cosmetic as possible. The laparoscopic approach has proved its superiority over the open technique, although mini-laparotomy is generally performed to prepare for the anastomosis.
  
  
  METHODS
  Total laparoscopic approach in patients with partial bowel stenosis, using the vagina for specimen extraction.
  
  
  CONCLUSIONS
  This technique of intracorporeal anastomosis with transvaginal specimen extraction enables a smaller resection and avoidance of abdominal incision enlargement that may cause hernia, infection, or pain. When stenosis is partial, this technique seems particularly suited for treatment of bowel endometriosis requiring resection. If stenosis is complete, the anvil can be inserted above the lesion transvaginally.
authors: Service de Chirurgie Gynecologique, Clinique Axium, Aix en Provence, France. faller_emilie@hotmail.com
authors: Emilie
authors: E
authors: Faller
authors: Jaime
authors: J
authors: Albornoz
authors: Pietro
authors: P
authors: Messori
authors: Joël
authors: J
authors: Leroy
authors: Arnaud
authors: A
authors: Wattiez
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods; D004715:Endometriosis / Q000601:surgery*; D005260:Female; D006801:Humans; D007410:Intestinal Diseases / Q000601:surgery*; D007422:Intestines / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D057605:Natural Orifice Endoscopic Surgery; D012007:Rectum; D014621:Vagina