Robotic-assisted surgery and the NOSE technique in the treatment of colorectal endometriosis

Background. Natural orifice specimen extraction (NOSE) is an innovative technique of endoscopic surgery in which with specimen extraction through the natural orifice. The relevance of studying robot-assisted colorectal NOSE resection is driven by the need for an objective assessment of its advantages and safety.

Aim. To evaluate the safety and short-term clinical outcomes of robotic-assisted bowel resections with specimen extraction through the anal canal in patients with colorectal endometriosis.

Materials and methods. A retrospective cross-sectional study was conducted based on the analysis of data from 66 patients with confirmed deep infiltrative colorectal endometriosis. All patients underwent robot-assisted colorectal NOSE resection.

Results. The mean age of the patients was 35.4 years (range 23 to 49 years). The mean body mass index was 23.36 kg/m2 (range 16.65 to 33.12 kg/m2). The mean operative time for robotic-assisted colorectal resection using the NOSE technique was 144.6 ± 50.1 min. The mean intraoperative blood loss was 124.6 ± 90.8 mL. On postoperative day 2, 13 patients presented with a body temperature elevation up to 38°C.

Conclusion. Robotic-assisted laparoscopy combined with the NOSE technique is a technically feasible, safe, and effective approach in the comprehensive surgical management of colorectal endometriosis. The technique offers several advantages: reduction in the consumption of disposable instruments, absence of a laparotomic incision, accelerated postoperative rehabilitation.

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