SP6.02 Laparoscopic management of advanced (Grade IV) endometriosis: a joint venture or a solo journey?

Aims Advanced grade IV endometriosis affects between 3.8% to 37% patients, mostly affecting the rectovaginal septum. It is characterized by a myriad of symptoms. The Aim of the project was to assess the outcomes of the joint coloretal-Gynae lists for multi-visceral endometriosis. Methods This study is conducted at a tertiary care centre with data entered into the national registry over the last 10years. Cases were reviewed at the Endometriosis MDT followed by surgery. Analysis was performed to asses variables including peri-operative complications following rectal treatment; improvement in pain, fertility, conversion & return to theatre. Results The total number of joint procedures were 300. Majority had rectal shaving (97%), disc resection in 4 (1.3%) and anterior resection 2(0.6%), & two stomas formed. Two patients had ureteric injury managed conservatively and 01open conversion with no unplanned return-to-theatre. Pelvic pain improved in 70-80%, & pregnancy was achieved in 35-40%. Conclusion Tertiary centre MDT with experienced radiologists, gynaecologists, colorectal surgeon, & nurse specialists adhering to the core GIRFT principles are essential for high quality patient outcomes. The Expertise of a colorectal surgeon helps organ preservation and better functional outcomes, thus achieving a high success rate and patient satisfaction.