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Successful detection of rectal injury during laparoscopic surgery using a rectal probe in a patient with deep endometriosis
Author(s) -
Yoriki Kaori,
Kusuki Izumi,
Kawamata Mari,
Tarumi Yosuke,
Mori Taisuke,
Kitawaki Jo
Publication year - 2021
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.14535
Subject(s) - medicine , endometriosis , surgery , laparoscopic surgery , laparoscopy , colorectal surgery , rectum , leak , fistula , abdominal surgery , gynecology , environmental engineering , engineering
Laparoscopic surgery has become the gold standard treatment for endometriosis. Surgical treatment of deep endometriosis with colorectal involvement is challenging. It requires complete surgical excision of lesions despite a high risk of complications that include rectal injury, rectovaginal fistula and pelvic abscess. An intraoperative air leak test allows detection of rectal injury and reduces postoperative complications. We report a case of successful management of rectal injury during laparoscopic surgery using a rectal probe even though air leak tests were negative. A 45‐year‐old woman with severe endometriosis and rectal involvement underwent total laparoscopic hysterectomy combined with rectal shaving. A pinhole injury that reached the rectal muscularis layer without breaching the mucosal layer was identified using a rectal probe after negative air leak tests. The injury was repaired uneventfully. Our experience suggests that using a rectal probe could be helpful for early detection and safe repair of rectal injury during surgery.