A multidisciplinary, minimally invasive approach for complicated deep infiltrating endometriosis

Abstract

Objective: To present a case of complicated deep infiltrating endometriosis managed by a multidisciplinary minimally invasive approach.

Design: Case report.

Setting: Tertiary care university hospital.

Patient: A 32-year-old woman with deep infiltrating endometriosis involving the rectovaginal septum, the rectum, and the left ureter, complicated by silent left renal function loss.

Intervention(s): Laparoscopic left nephrectomy, ureterectomy, excision of a left ovarian endometrioma, removal of a large rectovaginal nodule, and segmental bowel resection with minilaparotomic end-to-end anastomosis.

Main outcome measure(s): Multidisciplinary diagnosis and minimally invasive surgical approach to deep infiltrating endometriosis involving the rectum and the urinary tract.

Result(s): Collaboration between gynecologists, urologists, and colorectal surgeons enabled a successful management of the case in one surgical intervention providing minor risk of complications, shorter hospital stay, and faster functional recovery.

Conclusion(s): Deep infiltrating endometriosis is a global pathology that may involve different structures. A multidisciplinary, minimally invasive approach should be recommended to achieve appropriate disease management.