Objective: To compare three methods of segmental lower colon resection for treatment of symptomatic intestinal endometriosis. Design: Retrospective case study. Setting: Private practice patients in a rural community hospital. Patients: Patients with nodular, invasive rectosigmoid endometriosis requiring segmental resection and anastomosis for treatment. Laparotomy patients were matched with laparoscopy patients for severity of intestinal endometriosis. Interventions: Segmental resection of the rectosigmoid colon by laparotomy, by a laparoscopic intracorporeal technique or by a laparoscopically assisted transvaginal technique. Main Outcome Measures: Length of surgery, length of hospital stay, operating room charges and total hospital charges corrected to 1995 dollars. Results: Compared with laparotomy segmental colon resection for endometriosis, laparoscopic transvaginal segmental resection resulted in shorter length of stay, equivalent operating a room charges, and significantly lower total hospital charges. The laparoscopic transvaginal technique is much faster, safer, and less fatiguing to the surgeon than a total intracorporeal technique. Conclusions: Laparoscopically assisted transvaginal segmental rectosigmoid resection for endometriosis is a promising technique that is simpler than a laparoscopic intracorporeal segmental resection technique and is less costly than a laparotomy segmental resection technique.
