Introduction/Background Presenting the method of laparoscopic anterior rectal resection andretransplantation of the ureter in the case of deep infiltrating endometriosis(DIE)

Methodology 28 – year old lady with the history of dyschezia 9/10, dysmenorhoea 9/10,dyspareunia 6/10, dysuria 7/10, infertility, left huge hydronephrosis whichwere explained by urologist as a consequence of anatomical variation of thevassel.She had the trial of cystoscopical ureteric JJ stent insertion prior to plannedsurgery with no success. 2 weeks later she had done laparoscopic

Results She had done segmental resection of the anterior rectum with the end to endrecto- sigmoid colon anastomosis due to 6 cm nodule of the rectum, theintraabdominal insertion of the JJ stent to the left ureter after cutting the wall ofureter 10 cm from the bladder due to impossible JJ cystoscopical stenting withsimultaneous retransplantation of the left ureter. All procedure was done incontrol of vascularity by ICG both the bowel and the ureter. Both anastomosis ofthe colon and the uretero-bladder were protected by fibrine glue. The bladderwas isolated from rectum with the flap of omentum. 5 weeks after surgicalprocedure the JJ stent was removed from the ureter. Proper function of thebowel and the ureter were proved in control visit – 6 weeks after surgery.In histopathology: endometriotic nodule of the bowel and ureter werediagnosed.The result of the surgery was complete realising from the pain and tailoredsurgery on colon and ileum due to low grade neoplasma of appendix.

Conclusion Laparoscopy is a perfect method for tailored and radical surgery inDIE and multiorgans surgery with all advantages of the minimally invasiveaccess. Complete realising of the pain was huge success of the surgery.