Patient-Reported Outcomes after Robotic Resection of Deep Endometriosis of the Bowel

Poppy Addison, Addison P, Stewart K, Kelsey Stewart, Ferrari D, Davide Ferrari, Garfinkle R, Richard Garfinkle, Robert A. Vierkant, Vierkant RA, Perry W, William Perry, David W. Larson, David Larson, Larson D, Adela Cope, Cope A, Adela G. Cope, Zaraq Khan, Khan Z, Carrie Langstraat, Langstraat C, Tatnai L. Burnett, Tatnai Burnett, Burnett T, Behm K, Kevin Behm
Diseases of the colon and rectum · 2026 · doi:10.1097/dcr.0000000000004492 · PMID:42974830 · W7225144852
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⚙ AI-generated summary by qwen3.7-flash, 2026-11-05 ⓘ

A retrospective review of 41 patients undergoing robotic resection for bowel endometriosis found significant postoperative improvements in pain scores and bowel function satisfaction, with most patients reporting reduced pain impact on work at one year.

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⚙ AI-generated deep summary by qwen3.7-flash, 2026-11-05 · read from full text ⓘ

This retrospective cohort study evaluated patient-reported functional outcomes following multidisciplinary robotic resection for deep endometriosis involving the bowel at a single tertiary academic institution. The analysis included 41 patients who completed preoperative and postoperative surveys, revealing significant reductions in overall pain scores and specific menstrual-related pain from baseline to 12 months post-surgery. Additionally, the proportion of patients reporting that pain impacted their work decreased substantially, while satisfaction with bowel function improved significantly over the same period. Despite these positive findings, the authors noted limitations including a low response rate at the 12-month mark, a retrospective design, and limited demographic diversity within the patient population. This paper is centrally about endometriosis — specifically focusing on surgical management and quality of life outcomes for deep infiltrating disease affecting the bowel.

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Abstract

BACKGROUND: While minimally invasive surgery is the current surgical standard of care for excision of deep endometriosis of the bowel, there is little literature evaluating patient-reported outcome measures following a multidisciplinary, robotic approach. OBJECTIVE: This study aimed to assess the functional outcomes of robotic surgery for patients undergoing resection of deep endometriosis involving the bowel. DESIGN: Retrospective cohort review. SETTINGS: A single academic tertiary institution. PATIENTS: Patients with endometriosis of the bowel undergoing multidisciplinary resection between January 1, 2018, and October 1, 2023. MAIN OUTCOME MEASURES: A survey assessing functional outcomes on a Numeric Rating Scale preoperatively and at multiple points postoperatively. RESULTS: Of 92 eligible patients, 41 completed a preoperative survey and at least one postoperative survey. Among these 41 patients, overall pain improved postoperatively from 5.3 ± 2.7 (Numeric Rating Scale) to a nadir of 1.6 ± 1.9 at 6 months and 2.3 ± 3.0 at 12 months (p < 0.001). Preoperative pain at ovulation (mean 4.2 Numeric Rating Scale ± 3.7), pre-period pain (4.9 ± 3.5), period pain (5.7 ± 3.6) and post-period pain (3.3 ± 3.3) all decreased to a mean of 1 at 12 months postoperatively (p < 0.001). The proportion of patients reporting pain impacting work decreased from 88% preoperatively to <40% postoperatively (p < 0.001). The proportion of patients happy with their bowel function increased from 39% preoperatively to 63.2% at 1 month, 80.0% at 6 months, and 69.2% at 12 months postoperatively (p = 0.014). LIMITATIONS: Only 31.7% of patients responded to their 12-month survey, tertiary care center, low diversity in patient demographics, retrospective design. CONCLUSION: In this cohort of patients undergoing multi-disciplinary robotic excision for advanced endometriosis involving the bowel, patients reported significantly improved pain and quality of life measures. See Video Abstract.
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Background

While minimally invasive surgery is the current surgical standard of care for excision of deep endometriosis of the bowel, there is little literature evaluating patient-reported outcome measures following a multidisciplinary, robotic approach.

Objective

This study aimed to assess the functional outcomes of robotic surgery for patients undergoing resection of deep endometriosis involving the bowel. DESIGN: Retrospective cohort review. SETTINGS: A single academic tertiary institution. PATIENTS: Patients with endometriosis of the bowel undergoing multidisciplinary resection between January 1, 2018, and October 1, 2023. MAIN OUTCOME MEASURES: A survey assessing functional outcomes on a Numeric Rating Scale preoperatively and at multiple points postoperatively.

Results

Of 92 eligible patients, 41 completed a preoperative survey and at least one postoperative survey. Among these 41 patients, overall pain improved postoperatively from 5.3 ± 2.7 (Numeric Rating Scale) to a nadir of 1.6 ± 1.9 at 6 months and 2.3 ± 3.0 at 12 months (p < 0.001). Preoperative pain at ovulation (mean 4.2 Numeric Rating Scale ± 3.7), pre-period pain (4.9 ± 3.5), period pain (5.7 ± 3.6) and post-period pain (3.3 ± 3.3) all decreased to a mean of 1 at 12 months postoperatively (p < 0.001). The proportion of patients reporting pain impacting work decreased from 88% preoperatively to <40% postoperatively (p < 0.001). The proportion of patients happy with their bowel function increased from 39% preoperatively to 63.2% at 1 month, 80.0% at 6 months, and 69.2% at 12 months postoperatively (p = 0.014).

Limitations

Only 31.7% of patients responded to their 12-month survey, tertiary care center, low diversity in patient demographics, retrospective design.

Conclusion

In this cohort of patients undergoing multi-disciplinary robotic excision for advanced endometriosis involving the bowel, patients reported significantly improved pain and quality of life measures. See Video Abstract.

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