Princeton NJ gynecologist discusses endometriosis surgery with the daVinci robotic device.
In the video above, one of Dr. Eugene Gamburg's patients describes her experience undergoing a combined robotic surgical procedure with a surgeon at the University Medical Center of Princeton at Plainsboro, and how it saved her wedding day.
Dr. Seth Derman, our practice's fertility specialist also answers some frequently asked questions about this disease.
What is endometriosis?
Endometriosis is a disease in which tissue similar to the endometrium is located in places in the body where it normally does not belong. Endometrium is the layer of tissue that lines the uterus. It is where a pregnancy will implant, and part of it sheds monthly during the menstrual period. Endometriosis is typically found on the surfaces of organs near the uterus, the ovaries, the fallopian tubes, bladder and intestines, although it may also be been seen in distant parts of the body.
What are the symptoms of endometriosis?
The most common symptoms of endometriosis are pelvic pain, painful menstrual periods and painful intercourse. Because the implants of endometriosis respond to hormones similarly to normal endometrium, which fluctuate throughout the month, the symptoms of this disease are are often cyclic.
How is endometriosis diagnosed?
Endometriosis can only properly be diagnosed using surgery to directly inspect for it, and possibly confirm the diagnosis by biopsy. Routinely subjecting women to laparoscopy or other surgery is not practical, so oftentimes, the diagnosis of endometriosis is presumed without confirming the diagnosis.
How is endometriosis treated?
Your doctor may treat endometriosis in a number of ways. Sometimes this involves surgery, but it usually involve medications that suppress ovulation cause the implants to shrink down. This may include progesterone like drugs (progestins) and birth control pills that create a pregnancy-like hormone environment or drugs like Lupron, the create a temporary menopause-like situation. These medications often work because Endometriosis symptoms typically improve with pregnancy and menopause.
What is daVinci robotic surgery about?
Laparoscopy which involves a inserting a telescope into the abdomen is commonly used to diagnose and treat endometriosis. The daVinci surgical robot is a device often used to complete surgeries laparoscopically that are difficult to do without open surgery. Because it enables the surgeon to see far greater detail and operate with greater precisions, many gynecologists will use robotic surgery to treat the disease. Our team of gynecologic surgeons is among the most experience in DaVinci and minimally invasive surgery in the area.
Does endometriosis affect fertility?
This answer to the this question is a bit more complicated. Advanced staged endometriosis (stages 3 and 4) can clearly cause infertility. With early stage endometriosis (stages 1 and 2), it is a little less straightforward. While there is reasearch to suggest that treating early stage disease helps to improve pregnancy rates, there are other data which shows women with early stage endometriosis have similar outcomes to those with unexplained infertility. Either way, it is important to understand that even in couples with endometriosis-related infertility, there may be other reasons for not conceiving, so it is still important to see a fertility specialist for a testing.