In this video, the authors demonstrate an alternative technique with a natural orifice specimen extraction (NOSE) laparoscopic sigmoidectomy and hysterectomy in a 45 year-old female patient diagnosed with endometriosis with implants on sigmoid colon and uterus. The key operative steps are outlined. This video highlights the consensual guidelines for a sigmoidectomy, adding the specimen (containing 13 cm of sigmoid colon and 6cm of rectum) extraction through the vagina (natural orifice) that immensely reduced postoperative morbidity, with reduced scaring. Post-operatively a she made full recovery without symptom recurrence. The pathology analysis reported endometriosis implants on the serosa, muscle and submucosa as well as pericolic adipose tissue. Resection margins were free of lesions.