Introduction/Background Anastomotic leakage is one of most serious complications of intestinal surgery. Our task is to compare two laparoscopic techniques in different risk factors of bowel anastomosis leakage in DIE patients.

Methodology We divided 138 patients into 2 groups: Group A: 30 patients with classical ‘surgical’ technique of bowel resection. Group B: 100 patients who had laparoscopic ‘tailored’ bowel segmental resection with ICG vascular visualization and fibrin sealant use. Both groups were dived into supgroups due to complexity of the surgery. Different risk factors of anastomotic leakage were taken into analysis.

Results (1) The occurrence of bowel anastomosis leakage was higher in group A 3/30 3/30 (10%) than in group B – 2/100 (2%) (2) Low localisation of the tumor (below 60 mm) – 4 cases in group A was connected with 1 leakage (25%), in group B – 10 cases, - 1 – leakage (10%) (3) Complexity of the surgery and anastomotic leakage – group A1 – only bowel – 12,5% (2/16) of leakage, group A2 – bowel and uterus -7,2% (1/14), group B1 – only bowel- no leakage, group B2 – bowel and uterus- 2,7% leakage (1/36), group B3 – bowel and urinary tract organ – no leakage (0/5), group B4 – bowel with urinary tract organ and uterus – 5.2% (1/19) of leakage, group B5 – multiple segments of bowel with uterus and urinary tract organs – no leakage.

Conclusion (1) The ‘tailored’ bowel resection, with ICG visualization and usage of fibrine material reduce the number of anastomosis leakage to 2% (2) Complexity of the surgery has the impact on the risk of leakage. (3) The low localisation of the endometriotic changes has the impact on higher risk of anastomosis leakage, but using modified laparoscopic technique reduces it compared with classical one.