Laparoscopically assisted transvaginal segmental resection of the rectosigmoid colon for endometriosis

To compare three methods of segmental lower colon resection for treatment of symptomatic intestinal endometriosis. Retrospective case study. Private practice patients in a rural community hospital. Patients with nodular, invasive rectosigmoid endometriosis requiring segmental resection and anastomosis for treatment. Laparotomy patients were matched with laparoscopy patients for severity of intestinal endometriosis. Segmental resection of the rectosigmoid colon by laparotomy, by a laparoscopic intracorporeal technique or by a laparoscopically assisted transvaginal technique. Length of surgery, length of hospital stay, operating room charges and total hospital charges corrected to 1995 dollars. Compared with laparotomy segmental colon resection for endometriosis, laparoscopic transvaginal segmental resection resulted in a shorter length of stay, equivalent operating room charges, and significantly lower total hospital charges. The laparoscopic transvaginal technique is much faster, safer, and less fatiguing to the surgeon than a total intracorporeal technique. Laparoscopically assisted transvaginal segmental rectosigmoid resection for endometriosis is a promising technique that is simpler than a laparoscopic intracorporeal segmental resection technique and is less costly than a laparotomy segmental resection technique.