Choosing the Right Laparoscopic Specialist Matters
Choosing an experienced laparoscopic GYN surgeon has a direct impact on your endometriosis excision recovery. Endometriosis is an extremely complex condition that varies from woman to woman. The location and severity of the disease is not always indicative of the amount of pain a woman experiences. Some women can have extensive endometriosis and experience little pain, while another woman may only have small lesions that happen to affect very sensitive areas like the bowel or nerves. Due to its erratic nature, choosing a specialist who has performed thousands of endometriosis excision procedures is important.
What Should I Expect My Surgeon To Look For?
Endometriosis occurs when cells like those within the endometrium (the lining of the uterus that either an embryo attaches to or sheds monthly during a woman’s period) are present outside of the lining. This can occur localized to the uterus where the cells grow into the uterine muscle (Adenomyosis) or outside of the uterus in other areas of the body.
These endometrial cells behave exactly like those within the uterine lining. Each month they thicken, swell and when the time comes, they bleed. Since there is no pathway out of the body, the body responds through inflammation. Lesions form. These lesions often appear in the pelvic cavity including the outside of the uterus, the bladder, the bowel, etc., but have also been detected on the lungs and the brain.
The longer a woman has to wait for an endometriosis diagnosis, the more damage can occur. In many cases, women begin to experience symptoms from their first menstrual cycle, but are told that cramping can cause pain, so over time, many women learn to expect the pain and simply live with it until it escalates or until fertility is affected.
Will All Of The Endometriosis Be Removed?
Thorough removal of the endometriotic lesions is possible for many patients. Once a patient is through recovery, there should be a noticeable difference in the level of pain. In many cases, all of the lesions can be removed and the resulting pelvic adhesions that develop through constant cycles of inflammation can also be removed, freeing the organs from sticking together in the pelvic cavity. This should help patients who have had difficulty going to the bathroom.
However, in some cases, depending on the extent of the endometriosis, and the patient’s desire for fertility, the surgeon may have to take a conservative approach to removal in order to preserve the ovaries, fallopian tubes and uterus.
Every patient is evaluated on a case by case basis and fertility if possible is taken into consideration. Once fertility is no longer desired, additional procedures can be performed to remove remaining endometriosis or adhesions.
My Doctor Recommended A Hysterectomy. Why Is Excision Necessary?
Many doctors perform hysterectomy for endometriosis, and while in some cases that may alleviate the pain, if the endometriosis is not localized to the uterus or the ovaries, and lesions are left behind, the patient will still experience pain.
If hysterectomy for endometriosis is indicated, it must be performed by a specialist who can also identify and resect endometriosis completely, and repair the areas where the lesions are removed. In many cases, endometriosis appears on the bowel or the bladder. It is essential that the surgeon has the skills and experience to repair these organs during the same procedure for the safety of the patient.
There is no cure for endometriosis. Hysterectomy is only appropriate if the uterus is affected by the disease. Expert laparoscopic excision is more effective to alleviate the pain.
Why Shouldn’t My OBGYN or GP Perform My Endometriosis Surgery?
The skills required to perform a laparoscopic endometriosis excision procedure are not practiced by generalists, including OBGYNs. An OBGYN practice is primarily focused on obstetrics and according to ACOG, the average number of hysterectomy procedures performed annually by an OBGYN is just 27. Many of these procedures are performed as open surgeries, especially if the patient is suffering from an enlarged uterus or large fibroids.
In 2016, the CIGC specialists performed over 2,000 laparoscopic GYN procedures. To understand the importance of experience with complex conditions, CIGC specialists have:
- removed more than 100 fibroids during one procedure,
- removed extremely large fibroids, including one that was 20 lbs;
- performed extensive endometriosis excision with resection of pelvic adhesions that essentially freeze the pelvis;
- welcomed women to our practice from around the world, including Jakarta, Indonesia.
CIGC performs high volume laparoscopic surgery at a high level of expertise for some of the most complex GYN conditions that cannot be treated by other surgeons unless the surgery is performed as an open procedure.
How Long Is The Endometriosis Removal Procedure?
The average laparoscopic endometriosis removal procedure at CIGC is less than an hour. Some procedures may take longer.
The advanced-trained CIGC specialists have developed techniques that ensure efficiency in every surgical procedure, including endometriosis removal. These techniques control for blood loss and map the pelvic cavity so that visibility is high, and time can be spent removing and repairing.
The less time under anesthesia is better for the patient, but it is important to also perform a thorough procedure. Using these techniques, CIGC specialists can achieve both.
Will I Have To Spend Days At The Hospital?
All procedures performed by CIGC specialists are outpatient. That means patients go home from surgery the same day. There is no hospital stay.
How Long Is The Endometriosis Excision Recovery?
Endometriosis excision is performed using just two tiny incisions, that both avoid the abdominal muscle, so the pain from surgery is significantly less than if it were performed as a standard laparoscopic or robotic procedure.
Most women are back to their normal activities within one week or less.
BOOK A CONSULTATION
The CIGC state-of-the-art specialists are available at three locations in the DC metro area. Virginia patients can visit the Reston, VA location, and Saturday appointments are available. Maryland offices are located in Rockville, MD and Annapolis, MD.
CIGC is dedicated to providing information and materials for women to help navigate the complicated healthcare system. The CIGC founders, minimally invasive GYN surgical specialists Dr. Paul MacKoul, MD and Dr. Natalya Danilyants, MD, developed their advanced GYN surgical techniques using only two small incisions with patients’ well-being in mind. Dr. Rupen Baxi, MD is a CIGC-trained minimally invasive GYN specialist with extensive fellowship training and a respected speaker and researcher.
Their personalized approach to care helps patients understand their condition and the recommended treatment so that they can have confidence from the very start. Our surgeons have performed over 20,000 GYN procedures and are constantly finding better ways to improve outcomes for patients.