Design: Description of one case complete laparoscopic resection of deep bowel endometriosis, and explain the steps for a side to end colorectal anastomosis.

Setting: With the patient under general anesthesia, laparoscopy is performed with the patient in lithotomy position with a López-Zepeda manipulator, placement of 5 trocars, umbilical trocar of 12 mm, 2 trocars of 5 mm in the left side, 1 of 5 mm and 1 of 12 mm on the right side, pneumoperitoneum pressure at 12 mmHg. Linear and circular stapler to perform side-to-end anastomosis.

Patients or Participants: A 46 year’s old female presented with a history of chronic pelvic pain characterized by dysuria and disquecia, disabling dysmenorrhea and dyspareunia. She had undergone an open surgery in 2013 with described as a frozen pelvis without treatment. The MRI describes multiple leiomyomas, adenomyosis and a 3.5 cm deep endometriotic nodule in the rectum, also anterior, middle and posterior compartment endometriosis.

Interventions: Complete laparoscopic resection of deep endometriosis: hysterectomy with bilateral oophorectomy, bilateral parametrectomy with nerve-sparing technique and laparoscopic bowel resection with side-to-end colorectal anastomosis,

Measurements and Main Results:

The surgical treatment was performed successfully, there were no trans or post-surgical complications the surgical bleeding was 200 cc, the surgical time 190 minutes, the patient was discharge from hospital 72 hours after surgical event, at follow up at 34 moths the patient is without pelvic pain, voiding disfunction, defecatory disfunction or recurrence of the disease.

Conclusion: Side-to-side colorectal anastomosis is feasible after resection of deep bowel endometriosis; it should be performed by a multidisciplinary team with extensive knowledge of anatomy and nerve-sparing techniques. The available recent studies show similar complication rates and functional outcomes compared with an end-to end anastomosis.