Complex Endometriosis Center

As already stated, the sigmoid must be considered distinct organ from the rectum due to its smaller diameter, thinner wall and different anatomical location. The wall of the sigmoid, which is much thinner than that of the rectum, is far more vulnerable to shaving (greater risk of perforation).

On the other hand, its similar diameter both upstream and downstream of deep endometriosis lesions, as well as its free location in the pelvis, make it safer to use other techniques like short sigmoid resection with transsuture anastomosis (15). his is reflected in the complication rates, particularly in terms of digestive fistula. While the rate of rectovaginal fistula after rectal resection ranges from 10% to 18%, the risk of fistula after sigmoid resection is less than 1%(24). Since the sigmoid resides far from the hypogastric plexuses, there is no neurological involvement and patients do not need catheterization to empty the bladder.

These operations are performed at the CEC with the help of experienced visceral surgeons, who regularly carry out this type of surgery for other operative indications. Decisions on sigmoid resection are taken in multidisciplinary meetings involving joint consultations with experts on the same day in order to plan surgery with a variety of specialists used to working collaboratively.