I am a fellowship trained minimally invasive gynecologic surgeon. Passionate about optimizing perioperative outcomes for women undergoing surgery. I specialize in advanced laparoscopy and complex pelvic surgery, with a special interest in complex endometriosis.
March is endometriosis awareness month. Endometriosis affects 10% of women in the reproductive age group. Endometriosis affect the patients’ quality of life and causes significant pain and infertility. Surgical excision is the standard of care. Deep endometriosis surgery is complex and requires advanced training and deliberate advancement of surgical skills. The goal of this presentation is to emphasize on how the integration between the surgical skills as well as the appropriate mindset will empower the surgeon to improve their performance.
Published
Mar 2024
The incidence of bowel injury during gynecological laparoscopic surgery is 0.03-0.18%. No significant difference in bowel injury rates between laparoscopic insufflation and Hassan entry. Risk factors include: Prior Laparotomy and Prior Bowel Resection Strategies to decrease the risk of complication include Palmer Point entry, Port Hoping, Sharp dissection, Additional ports. 41% of bowel injuries at gynecologic laparoscopy are diagnosed in a delayed manner; the mortality rate for these cases is 3.2%. The goal of this surgical classroom is to discuss early diagnosis treatment and prevention of gastrointestinal injuries during gynecological laparoscopy.
Published
Aug 2023
Incidence of urological complications during gynecological surgery varies between 0.03–1.5% (ureteral) and 0.2–1.8% (bladder) Up to 75% with uncomplicated hysterectomy 18.6% of ureteral injuries and 5.5% of bladder injuries were of delayed identification. In this surgical open classroom we will discuss the incidence, the causes, the risk factors of urological injuries during gynecological laparoscopy as well as methods to prevent those injuries and how to recognize them in timely fashion and appropriately address them as indicated.
Published
Jul 2023
Endometriosis is an inflammatory condition defined by the presence of endometrium-like tissue outside the uterus. Deep lesions are characterized by the presence of endometrial implants, fibrosis and muscular hyperplasia, affecting 15-30% of the women suffering from endometriosis. Colorectal disease represents almost 90% of these cases. Clinical presentation includes; cyclic bowel alterations, dyschezia and rectal bleeding. Rectal stenosis was observed in 26.4%. Preoperative imaging is crucial in determining the appropriate surgical intervention with transvaginal ultrasound and MRI. Surgical intervention depends on the size and number of lesions and can include rectal shaving, discoid excision, and resection anastomosis. Multidisciplinary surgical management with a team including a gynecologist with expertise in endometriosis and a colorectal surgeon is key to achieving the best outcomes.
Published
Dec 2021
The urinary tract is the second extragenital system most frequently affected by deep infiltrating endometriosis (DIE). The incidence of urinary tract endometriosis ranges from 1% to 5.5% of all women affected by endometriosis, reaching 16.4–52.6% in patients with DIE. The most common type of ureteral endometriosis (80%) is extrinsic, which involves the adventitia. Intrinsic involvement affects the muscularis propria, lamina propria, or ureteral lumen. Treatment goals for ureteral endometriosis include: relieving the ureteral obstruction, preserving renal function, and preventing disease relapse. Medical therapy is contraindicated in ureteral obstruction due to the risk of progressive ureteral stenosis and hydronephrosis, as well as loss of renal function.
Published
Sep 2021
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