Bowel complications in endometriosis surgery.

Endometriosis surgery by laparoscopy or laparotomy can be associated with various types of intestinal complications that may occur in the immediate postoperative period or later. They include bowel anastomotic dehiscence, rectovaginal fistula, anastomotic bleeding, intra-abdominal infections, wound infections, bowel stricture, intestinal obstruction, chronic constipation, and diarrhea. There is growing evidence that bowel injuries can be repaired by primary closure in two layers even without previous bowel preparation. Surgical treatments of deep bowel endometriosis include conservative surgery (including shaving technique or discoid resection) or a more radical approach such as bowel resection that is associated with increased complications. Good perfusion and no tension at the anastomosis site are essential when segmental resection is performed. Early recognition of bowel complications during surgery or in the immediate postoperative period is fundamental to decreased morbidity and mortality. This chapter will deal with the prevention of bowel complication in minimally invasive surgery for endometriosis.