title: Robotic surgery for deep endometriosis: a paradigm shift.
abstract: BACKGROUND
  Minimally invasive surgery represents the gold standard for the management of deep infiltrating endometriosis (DIE). This study aimed to evaluate the feasibility of robotic surgery for the management of DIE.
  
  
  METHODS
  A 5-year retrospective cohort study was made of robotic procedures including: segmental bowel resections, removal of nodules from the rectovaginal septum (RVS) with or without rectal shaving and partial bladder resection.
  
  
  RESULTS
  Overall, 19 bowel resections, 23 removals of RVS nodules and five bladder resections were performed, alone or in combination. Associated posterior vaginal resections were performed in 12 cases. Neither intra-operative complications, nor conversion to laparotomy occurred. One anastomotic leakage was recorded.
  
  
  CONCLUSIONS
  This series of robotic procedures for DIE represents the largest currently available and it helps to promote robotics as a safe and attractive alternative to accomplish a comprehensive surgical treatment of DIE, especially when bowel or bladder resections are needed.
authors.affiliation: Department of Gynecology, IRCCS, Humanitas Clinical and Research Center, Rozzano, Milan, Italy.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Siesto
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Ieda
authors.forename: Riccardo
authors.initials: R
authors.lastname: Rosati
authors.forename: Domenico
authors.initials: D
authors.lastname: Vitobello
mesh_terms: D000328:Adult; D015331:Cohort Studies; D004066:Digestive System Diseases / Q000473:pathology / Q000601:surgery; D004715:Endometriosis / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D001745:Urinary Bladder Diseases / Q000473:pathology / Q000601:surgery
keywords: bladder endometriosis; bowel endometriosis; deep infiltrating endometriosis; robotic-assisted laparoscopic surgery; segmental bowel resection