Can bowel endometriosis surgery cause an anastomotic leak?

Yes—any time endometriosis surgery involves cutting and reconnecting the bowel (for example, a segmental resection), a leak at that connection is a known potential complication. Not every bowel endometriosis procedure carries the same risk: techniques like superficial “shaving” of disease on the bowel wall generally differ from disc excision or full segmental resection, and the risk profile changes with how deep the disease is and what has to be repaired.

The good news is that leaks are uncommon in experienced hands, and risk is largely about planning and technique—accurate pre-op mapping, choosing the least invasive bowel approach that still fully treats the disease, and having the right multidisciplinary team available when the rectum/sigmoid colon are involved. In our practice, we emphasize meticulous robotic excision for precision and tissue handling, which is especially important in complex, scarred anatomy.

If you’re considering surgery for suspected bowel endometriosis, we encourage you to explore how different bowel procedures are selected and what your individualized surgical plan would include (including who will be in the operating room and what safeguards are used). Our team can review your symptoms and imaging, explain which bowel technique may be appropriate for your case, and walk you through complications like leaks in a clear, practical way during a consultation.