Application of NOSE technique for laparoscopic large bowel resection in patients with infiltrating endometriosis
Ovodenko D.L., Cheknizov F.V., Maltsagov M.R., Chuprynin V.D.
Laparoscopic surgery for colorectal endometriosis is used due to necessity for large bowel resection and application of сircular stapling anastomosis. Natural Orifice Specimen Extraction (NOSE) is a technique that makes it possible to perform step-by step procedures for intestinal fragments extraction and installation of extraction device without using minilaparotomy. NOSE surgery is less painful and provides a cosmetic effect without worsening treatment results.
Objective: To assess the effectiveness and safety of NOSE technique for laparoscopic large bowel resection in patients with colorectal endometriosis.
Materials and methods: The study was carried out from 2023 to 2025 at the Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia. A total of 15 patients who underwent NOSE surgery, and 45 patients who underwent bowel resection using minilaparotomy were examined. The duration of surgery, blood loss, postoperative pain (according visual analog scale (VAS) scores), the length of hospital stay, and treatment outcomes were assessed.
Results: The duration of surgery, the length of hospital stay in the studied groups of patients were almost similar. Also, there were no differences in treatment outcomes. Pain intensity in the group of women who underwent NOSE surgery was significantly lower on the third day after surgery.
Conclusion: The use of NOSE technique for laparoscopic large bowel resection in patients with colorectal endometriosis makes it possible to achieve the effectiveness and safety comparable with conventional surgical approach. Moreover, there was reduction of postoperative pain and better cosmetic effect after surgery.
Authors' contributions: Ovodenko D.L., Chuprynin V.D. – the concept and design of the study; Cheknizov F.V. – manuscript writing and statistical data processing; Maltsagov M.R., Ovodenko D.L. – manuscript editing.
Conflicts of interest: The authors have no conflicts of interest to declare.
Funding: The study was carried out without any sponsorship.
Gratitude: The authors express gratitude to the doctors of the Department of Innovative Oncology and Gynecology of the Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia: Mamedov Sh.Ya., Sheshko P.L., Pronin S.M. (PhD), Shebzukhova Z.P., Vanakova A.I., Litvinova V.V., Dvoynishnikova A.O. for their assistance in patient management and surgical treatment.
Ethical Approval: The study was approved by the Local Ethics Committee of the Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia.
Patient Consent for Publication: The patients have signed informed consent for publication of their data and associated images.
Authors' Data Sharing Statement: The data supporting the findings of this study are available on request from the corresponding author after approval from the principal investigator.
For citation: Ovodenko D.L., Cheknizov F.V., Maltsagov M.R., Chuprynin V.D. Application of NOSE technique for laparoscopic large bowel resection in patients with infiltrating endometriosis.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2025; (4): 85-93 (in Russian)
https://dx.doi.org/10.18565/aig.2025.100
Keywords
infiltrating endometriosis
laparoscopy
NOSE
large bowel resection
postoperative period
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Received 11.04.2025
Accepted 22.04.2025
About the Authors
Dmitry L. Ovodenko, Dr. Med. Sci., Head of the Department of Innovative Oncology and Gynecology, Academican V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 4 Ac. Oparin str., Moscow, 117997, Russia, +7(495)531-44-44, +7(903)536-68-86,d_ovodenko@oparina4.ru, https://orcid.org/0000-0003-0700-8374
Fedor V. Cheknizov, 2nd year clinical resident, Department of Obstetrics and Gynecology, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University), 8-2, Trubetskaya str., Moscow, 119991, Russia; Academican V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 4 Ac. Oparin str., Moscow, 117997, Russia, +7(916)412-66-54, fedo7700@mail.ru, https://orcid.org/0009-0005-1748-7630
Muslim R. Maltsagov, oncologist-gynecologist, Department of Innovative Oncology and Gynecology, Academican V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 4 Ac. Oparin str., Moscow, 117997, Russia, +7(926)751-30-40, terekman94@gmail.com
Vladimir D. Chuprynin, PhD, Head of the Surgical Department, Academican V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 4 Ac. Oparin str., Moscow, 117997, Russia, v_chuprynin@oparina4.ru, https://orcid.org/0009-0003-7856-2863
Corresponding author: Fedor V. Cheknizov, fedo7700@mail.ru
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