Robot-assisted surgery for the radical treatment of deep infiltrating endometriosis with colorectal involvement: short- and mid-term surgical and functional outcomes

作者：Morelli Luca; Perutelli Alessandra; Palmeri Matteo; Guadagni Simone; Mariniello Maria Donatella; Di Franco Gregorio; Cela Vito; Brundu Benedetta; Salerno Maria Giovanna; Di Candio Giulio; Mosca Franco

来源：International Journal of Colorectal Disease, Clinical and Molecular Gastroenterology and Surgery, 2016, 31(3): 643-652.

DOI：10.1007/s00384-015-2477-2

• Robotic surgery
• Deep infiltrating endometriosis
• Colorectal resection
• Sexual dysfunction
• Urinary dysfunction
• Nerve-sparing surgery

Purpose Sexual and urinary dysfunctions are complications in radical treatment of deep infiltrating endometriosis (DIE) with colorectal involvement. The aim of this article is to report the preliminary results of our single-institution experience with robotic treatment of DIE, evaluating intraoperative and postoperative surgical outcomes and focusing on the impact of this surgical approach on autonomic functions such as urogenital preservation and sexual well-being.
Methods From January 2011 through December 2013, a case series of 10 patients underwent robotic radical treatment of DIE with colorectal resection using the da Vinci System. Surgical data were evaluated, together with perioperative urinary and sexual function as assessed by means of self-administered validated questionnaires.
Results None of the patients reported significant postoperative complications. Questionnaires concerning sexual well-being, urinary function, and impact of symptoms on quality of life demonstrated a slight worsening of all parameters 1 month after surgery, while data were comparable to the preoperative period 1 year after surgery. Dyspareunia was the only exception, as it was significantly improved 12 months after surgery.
Conclusions Robot-assisted surgery seems to be advantageous in highly complicated procedures where extensive dissection and proper anatomy re-establishment is required, as in DIE with colorectal involvement. Our preliminary results show that robot-assisted surgery could be associated with a low risk of complications and provide good preservation of urinary function and sexual well-being.

• 出版日期2016-3