AGES XXIII Annual Scientific Meeting 2013 Abstracts & Program

AGES XXIII Annual Scientific Meeting 2013
Free Communications 1 - Thursday 7 March
complications recorded in the study population. Time to
create a pneumoperitoneum was significantly faster in the
XCEL bladeless trocar arm (mean difference 175 sec, p=
40Kg/ m 2 ). The remaining
37% (12) had a BMI < 25 Kg/m 2 ).
Surgery was completed laparoscopically in 21 (66%) women,
of whom 19 had pure excision of disease and a further 2
included hysterectomy. Laparotomy was performed in the
remaining 11 (34%), including 2 women who had pure
excision alone, 1 myomectomy, 7 hysterectomies (including
1 Crohns stoma refashioning and 1 de novo caecal resection)
and 1 anterior resection (3% of all cases).
A total of 23 women (72%) had fertility sparing surgery, in
whom 19 (83%) were performed laparoscopically.
There was a higher mean BMI in the laparoscopic group (30
Kg/m 2 ) when compared with the laparotomy group (26 Kg/
m 2 ). Only 1 out of the 11 in the laparotomy group had a BMI
> 30.
Three major complications occurred in the laparotomy
group, including 2 wound infections requiring surgical
debridement and 1 return to theatre for a pelvic/wound
abscess.
CONCLUSIONS: Obesity did not reduce the chances of
successfully completing the surgery laparoscopically, whereas
the addition of hysterectomy or bowel resection increased the
risk of laparotomy.
Complications occurred in the group undergoing laparotomy
and this group had the lower BMI when compared with the
laparoscopy group.
Laparoscopic rectal shaving of the disease in the majority
of cases is possible, with a subsequent very low anterior
resection rate and low complication rates, particularly in
the fertility sparing group, as reported in other published
studies 2 .
REFERENCES:
1. Association of Endometriosis with body size and figure.
Hediger ML, Hartnett HJ, Louis GM. Fertil Steril 2005
Nov; 84 (5): 1366-74
2. Complications, Pregnancy and Recurrence in a
Prospective Series of 500 patients operated on by the
shaving technique for deep rectovaginal endometriotic
nodules. Donnez J, Squifflet J. Hum Reprod 2010:25(8):
1949-1958
AUTHOR AFFILIATION: S. Edmonds 1 , D. Barclay 1 , A.
Van der Merwe 1 , L. Israel 2 , S.-L. Peng 2 ; 1. Department of
Gynaecology, Middlemore Hospital, Auckland, New Zealand.
2. Department of Colorectal Surgery, Middle more Hospital,
Auckland New Zealand.
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