Objectives: To evaluate the novel modified laparoscopic technique of the bowel resection for deep infiltrated endometriosis (DIE) of the bowel versus the classical technique of bowel segmental resection in terms of anastomosis leakage. Material and methods: Patients (n = 138) treated with segmental bowel resections due to DIE were included; 30 patients had the classic, while 108 patients had the modified laparoscopic bowel segmental resection with indocyanine green vascular visualization and fibrin sealant use. Results:The modified technique was used more often in complex operations (65.7% vs 46.6%). More anastomotic leakages occurred in patients undergoing the classic technique than the modified technique (10% vs 2.8%; p = 0.117). No leakage in modified versus 12% in classic technique was observed in simple segmental bowel resections (p = 0.05); 2.5% of cases with leakage in modified versus 7.1% in classic technique were observed in bowel resections with hysterectomy. In complex cases operated with the modified technique, the frequency of anastomotic leakage was 4.2%, which were even less than leakage in simple cases in classic technique group (10%). Although the low location of the lesions increases the risk of leakage, the modified technique was associated with a small percentage of leakages (25% vs 6.3%). The laparotomy conversion rate was similar in both groups (3.4% for classic and 2.7% for modified). Conclusions:In DIE, the modified technique of segmental bowel resection showed superiority over the classic technique in terms of the risk of anastomotic leakage. This risk was lower regardless of the complexity of the surgery and lesion location.

2022-RA-993-ESGO Table 2 Unadjusted and adjusted for Age, BMI, EBL and OR time Primary Outcome and Secondary Outcomes Conclusion Our study offers a unique comparison of surgeonadministered cTAP blocks, showing similar analgesic effects with secondary benefits. Further prospective studies are needed to assess utilization of the cTAP block as routine post-operative analgesia.