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Re: Surgical access to the rectum--Follow-up questions

From: Angela (anonymous@obgyn.net)
Thu, 11 Feb 1999 16:04:58 -0600 (CST)


><< I'm wondering, when you have an endo implant on the rectum, how does a
> surgeon get at it to remove or zap it? Isn't the uterus in the way?
>
>****** Yes, the uterus may lie in the way, but it is easily movable during the
>procedure.
>
><< Can he access that area with a laparoscopic approach or is LAPAROTOMY
> needed?
>******* He can have access to the area.
>The Endometriosis is know to implant on the SURFACE of the large intestine
>(bowel) but it does not 'eat' through the muscular layers of the bowel.

>Because of this it is possible to destroy the implants with laser or cautery
>-- but -- it is a very tricky surgical procedure fraught with risk of
>penetration of the bowel. This can be a very serious complication.
>
>******* Perhaps one or more of the Doctors out there would comment. I always
>shied away from this Lapscope of bowel lesions.
>

>Dr. George

Thanks Dr. George! I have two follow up questions: 1) Are you saying that bowel perforation is less likely to occur if a surgeon approaches rectal endometriosis via a full abdominal incision? 2) I neglected to ask: if the uterus is enlarged ("10 week size" in my case), is it still possible to move it out of the way?




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