Surgical therapy remains the mainstay for the treatment of endometriosis. In this case report, we review the surgical management of a patient who presented with a cecal implant of endometriosis. She was successfully treated with combined laparoscopic hysterectomy and ileocecal resection. The laparoscopic ileocecal resection was completed with an intracorporeal anastomosis and retrieval of the specimen through the vaginal cuff. This presentation demonstrates the feasibility of combined colon resection and hysterectomy as well as vaginal colon specimen extraction. The vagina as a colon specimen retrieval site has significant implications for the future of natural orifice colorectal surgery
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