En Bloc Hysterectomy With Segmental Bowel Resection by NOSE-Procedure: Surgical Management of Ovarian Cancer in Context of Deep Infiltrating Endometriosis

Silva-Rengifo C.; Chaul L.; Cabrera-Carranco R.; Heredia Muñoz F. · Journal of Minimally Invasive Gynecology (2026) · DOI: 10.1016/j.jmig.2026.01.013

Resumen

Objective: To show the safety of en bloc hysterectomy with segmental bowel resection using the NOSE technique in the management of ovarian cancer and deep infiltrating endometriosis (DIE). Design: Demonstration of the technique with narrated video. Settings: Endometriosis, particularly endometriomas, increases the risk of epithelial ovarian cancer and complicates surgical management [1,2]. En bloc hysterectomy with NOSE-assisted anastomosis offers a less invasive, effective alternative, improving outcomes and recovery. Participant: A 39-year-old patient with DIE and an adnexal mass (ORADS-4) [3,4], diagnosed with endometrioid adenocarcinoma involving both ovaries (FIGO-Stage-IIB) [5]. Interventions: Laparoscopic en bloc hysterectomy with bowel resection and cytoreduction was performed, with intestinal anastomosis through the NOSE technique. Conclusions: En bloc hysterectomy with NOSE anastomosis reduces morbidity, enhances visualization and recovery, and achieves effective cytoreduction, offering a less invasive option for ovarian cancer with DIE. Video Abstract: [Figure presented]