Fig 1.
Current surgical approach to bowel endometriosis resection adopted by the Crispi Institute for Minimally Invasive Surgery – a private institution located in Rio de Janeiro, RJ, Brazil.
Although the linear stapler resection has been shown as a safe alternative to segmental colorectal resection for endometriotic nodules on the anterior rectal wall when less than one-third of the circumference is affected [63], it was not used in this series.
Fig 2.
Main steps of double circular stapler technique for colorectal deep endometriosis.
(1) The circular stapler 1 passes the lesion; (2) Opening the circular stapler; (3) Suture stitch limiting the area to be resected; (4) Suture to anchor the lesion; (5) Sutures forcing the lesion into the stapler; (6) Circular stapler closing; (7) Removing the circular stapler 1; (8) The circular stapler 2 passes the residual lesion; (9) Opening the circular stapler; (10) Suture stitch limiting the area to be resected; (11) Suture to anchor the lesion; (12) Sutures forcing the remaining lesion into the stapler; (13) Circular stapler closing; (14) Removing the circular stapler 2.
Table 1.
Individual characteristics prior to double circular stapler bowel surgery and at follow-up (prior to/ at follow-up).
Fig 3.
Study flow diagram-Double circular stapler technique (DCST).
All surgeries were performed by the Crispi Institute for Minimally Invasive Surgery team (Rio de Janeiro, Brazil).
Table 2.
Distances between the endometriotic bowel lesion and the anal verge, and important resections in the lateral compartments of the pelvis performed besides the double circular stapler bowel surgery.
Table 3.
Lower urinary tract symptoms prior to double circular stapler bowel surgery and at follow-up (prior to/ at follow-up).
Table 4.
Pelvic pain and use of hormones prior to double circular stapler bowel surgery and at follow-up (prior to/ at follow-up).
Table 5.
Bowel habits prior to double circular stapler bowel surgery and at follow-up (prior to/ at follow-up).
Table 6.
Previous pelvic surgeries (medical history) and reproductive outcomes prior to and after double circular stapler bowel surgery (prior to/ at follow-up).