Laparoscopic segmental resection of the sigmoid and rectosigmoid colon for endometriosis.

Patients with symptomatic endometriosis of the colon and distal small bowel usually present with crampy abdominal pain, pelvic and rectal pain, constipation, and dyspareunia. Superficial disease can be easily resected laparoscopically with scissors. Deeper lesions require full-thickness resection and closure of the bowel. Occasionally deep, large, or multiple lesions will require segmental resection for adequate control of the disease. Five patients with intestinal endometriosis underwent attempted laparoscopic segmental colon resection. Two patients required conversion to open laparotomy because of difficulty with the anastomosis. No operative complications or deaths occurred in this group. Those patients undergoing laparoscopic colectomy showed return of bowel function within 24 to 48 h and were discharged home on postoperative day 4.