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Surgical approaches to endometriosis continue to move towards greater levels of precision and efficacy as we learn more about the intricacies of this complex condition. Still, endometriosis continues to challenge gynecologic surgeons worldwide. How has endometriosis surgery evolved, and how can we apply what we’ve learned to continue to improve patient outcomes? In this episode of BackTable OBGYN, Dr. Tommaso Falcone, a renowned surgeon and expert in reproductive endocrinology and fertility, discusses the past, present, and future of endometriosis surgery.
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SYNPOSIS
Dr. Falcone shares his journey from McGill University to his current roles at the Cleveland Clinic, offering insights into advancements in minimally invasive surgery, the role of teamwork in medical innovation, and the complexities of treating endometriosis. The episode covers the evolution of surgical techniques, postoperative care, and fertility strategies, emphasizing the importance of managing patient expectations and the future directions for research and treatment.
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TIMESTAMPS
00:00 - Introduction
02:09 - Dr. Falcone’s Journey and Career
08:09 - Evolution of REI and MIGS
13:35 - Innovations in Endometriosis Treatment
20: 45 - Excision vs Ablation
25:30 - Challenges and Future Directions in Endometriosis Research
32:39 - Understanding the Placebo Effect in Chronic Pain
34:18 - Exploring Fibrosis in Endometriosis
35:31 - Challenges in Diagnosing and Treating Endometriosis
40:57 - Innovations in Surgical Techniques
53:56 - Managing Patient Expectations and Complications
56:06 - Concluding Thoughts -
Endometriosis is a very difficult disease to diagnose and manage, but effective imaging can make all of the difference. In this episode of the BackTable OBGYN podcast, Mayo Clinic radiologist Dr. Wendaline VanBuren and gynecologist Dr. Tatnai Burnett discuss the complexities of diagnosing, imaging, and surgically treating endometriosis.
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SYNPOSIS
The doctors delve into the importance of advanced imaging techniques such as MRI and dedicated protocols, the critical need for a multidisciplinary approach with radiologists and GYN surgeons, and the future potential of imaging in improving endometriosis diagnosis, treatment, and surgical planning. The discussion also covers the upcoming International Endometriosis Imaging Congress aimed at advancing standardized care and collaboration in the field.
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TIMESTAMPS
00:00 - Introduction
05:15 - Dr. VanBuren’s Journey to Endometriosis Imaging
08:24 - Dr. Burnett’s Surgical Training and Insights
11:57 - Challenges in Diagnosing and Understanding the Pathophysiology of Endometriosis
13:24 - The Role of Imaging in Surgical Planning
25:51 - Imaging Follow-Up, Monitoring for Malignant Transformation
32:03 - Protocol for MRI Imaging of Endometriosis
34:47 - The Role of Radiologists in Endometriosis
36:12 - The Complexity of Bowel Endometriosis
48:02 - The Future of Endometriosis Imaging
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RESOURCES
International Endometriosis Imaging Congress-March 8-9, 2025
https://eice.ltd/international-endometriosis-imaging-congress/ -
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Stay up to date on the latest advancements in gynecologic surgery. In this episode of the BackTable OBGYN Podcast, hosts Dr. Amy Park and Dr. Mark Hoffman invite Dr. Johnny Yi, a pioneer in the field of minimally invasive surgery and urogynecology, to discuss the latest advancements in, benefits of, and challenges with single port robotic gynecologic surgery.
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SYNPOSIS
The discussion covers evolutionary strides in robotic-assisted surgeries such as sacral colpopexy and myomectomies, the transition from traditional laparoscopy, and the intricacies of handling large uteri procedures. The episode also navigates the global adoption of these technologies, particularly in South Korea and Japan, and the varying applications in different specialties. Key topics include surgical skill requirements, training needs, innovative techniques, FDA approvals, and the future potential of single port surgeries. Overall, this discussion provides a well-rounded perspective on the current state and forward-looking innovations in the field of gynecologic surgery.
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TIMESTAMPS
00:00 - Introduction
03:57 - Single Port Robotic Surgery
08:27 - Benefits of Robotics with Sacral Colpopexy
11:37 - Technical Aspects of Single Port Surgery
14:40 - Training for Single Port Surgery
19:43 - Global Adoption and Future Potential of Single Port Surgery
25:35 - Access into the Abdomen
29:39 - Challenges and Innovations in Single Port Surgery
31:34 - Evaluating Risks and Success Rates
33:16 - Cost Analysis
35:16 - Training and Simulation for Single Port Surgery
39:35 - Future of Single Port and vNOTES Surgery
45:05 - Patient Reactions and Satisfaction
46:34 - Closing Techniques
52:14 - Future Prospects and Final Thoughts
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RESOURCES
Oh S, Yi J, Song AY, Jee J, Bae N, Shin JH. Intraoperative Complications and Perioperative and Surgical Outcomes of Single-Port Robotics-Assisted Sacrocolpopexy. Int Urogynecol J. 2024 Jul; 35 (7):1521-1526 Epub 2024 June 20. -
How can we address barriers to care for women with genitourinary syndrome of menopause? In this episode, host Dr. Suzette Sutherland and Dr. Rachel Rubin discuss the challenges and misconceptions around Genitourinary Syndrome of Menopause (GSM).
They identify the severity of symptoms such as pain, urinary issues, and recurrent infections that are often inadequately addressed. Dr. Rubin advocates for the use of vaginal estrogen, emphasizing that its benefits outweigh any perceived risks, contrasting it with other treatments like tamoxifen. The discussion includes the efforts to create guidelines for GSM through the American Urological Association (AUA) to standardize care, and the use of systemic and localized hormonal therapies, particularly in cancer patients. The session highlights the importance of updated medical practices and shared decision-making in treating GSM and related conditions.
TIMESTAMPS
00:00 - Understanding Genitourinary Syndrome of Menopause (GSM)
01:33 - Challenges, Misconceptions, and Advocacy
02:31 - Developing GSM Guidelines
04:34 - Hormonal Replacement Therapy and GSM
05:46 - Vaginal Rings
06:59 - Cancer Survivors and Vaginal Estrogen
09:17 - Shared Decision Making
CHECK OUT THE FULL EPISODE
OBGYN Ep. 33 - Genitourinary Syndrome of Menopause (GSM): Improving a DRY Topic
https://www.backtable.com/shows/obgyn/podcasts/33/genitourinary-syndrome-of-menopause-gsm-improving-a-dry-topic -
How can we educate women about vaginal estrogen for genitourinary syndrome of menopause, especially given the black box warning? In this Brief, Dr. Rachel Rubin and host Dr. Suzette Sutherland discuss misconceptions around the use of estrogen creams and suppositories, particularly focusing on dosage and application for safe, effective treatment.
They address common factors leading to inadequate results and the safety of low-dose vaginal estrogen. The doctors emphasize the importance of patience with treatment, correct understanding of hormone products, and education of patients to combat misinformation. Dr. Rubin and Dr. Sutherland also challenge misleading black box warnings associated with vaginal estrogen and stress the necessity for advocacy to update these labels and educate patients.
TIMESTAMPS
00:00 - Introduction
00:20 - Debunking Myths About Estrogen Cream Usage
04:10 - Safety and Proper Usage/Dosage of Estrogen Products
05:48 - Patient Education and Compliance
08:23 - Addressing the Black Box Warning on Vaginal Estrogen
10:48 - Conclusion
CHECK OUT THE FULL EPISODE
OBGYN Ep. 33 - Genitourinary Syndrome of Menopause (GSM): Improving a DRY Topic
https://www.backtable.com/shows/obgyn/podcasts/33/genitourinary-syndrome-of-menopause-gsm-improving-a-dry-topic -
Everyone knows about the dangers of opioids, but how can physicians provide quality postoperative pain control without opioids? This episode of the BackTable OBGYN podcast, hosted by Dr. Amy Park, features a discussion with experts Dr. Steven McCarus and Dr. Paula Bilica on non-opioid pain control in obstetric and gynecologic surgery.
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This podcast is supported by:
Pacira
https://www.pacira.com/
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SYNPOSIS
Highlighting the use of Exparel, a liposomal bupivacaine formulation, the discussion addresses how it has transformed post-operative pain management by reducing opioid exposure. The episode covers techniques for Exparel application in surgeries such as hysterectomies and C-sections, with positive patient outcomes noted. The conversation also emphasizes the importance of collaboration among healthcare professionals to advocate for better pain management protocols and patient satisfaction, spotlighting upcoming initiatives like the No Pain Act.
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TIMESTAMPS
00:00 - Introduction
04:47 - Introduction to Liposomal Bupivacaine (Exparel)
07:10 - Techniques and Applications of Exparel
20:13 - The No Pain Act
25:07 - Patient Success Stories with Exparel
26:30 - Administrative Hurdles and Solutions
30:24 - Safety and Efficacy of Exparel
32:42 - Educating Staff and Implementing Protocols
38:05 - Final Thoughts -
OBGYN Briefs - Managing Genitourinary Syndrome of Menopause
Frequent UTIs and vaginal atrophy/dryness are common signs of genitourinary syndrome of menopause (GSM). In this Brief, Dr. Rachel Rubin discusses the management of GSM and why estrogen is so vital to these tissues.
They address the lack of information and awareness about GSM among urologists and gynecologists while emphasizing its impact on the urinary and genital symptoms experienced by menopausal women. Dr. Rubin details how GSM is not just a matter of vaginal atrophy but involves broader symptoms like urinary tract infections and bladder issues. The doctors also discuss a range of treatment options available, including local vaginal supplementation products like estradiol creams and DHEA suppositories, and their benefits for urinary health.
TIMESTAMPS
00:00 - Introduction
00:20 - Understanding Genitourinary Syndrome of Menopause (GSM)
01:42 - Symptoms and Implications of GSM
03:00 - Vaginal Supplementation Products
05:09 - DHEA and SERM Therapy
08:44 - Estrogen and Vaginal Health
CHECK OUT THE FULL EPISODE
OBGYN Ep. 33 - Genitourinary Syndrome of Menopause (GSM): Improving a DRY Topic
https://www.backtable.com/shows/obgyn/podcasts/33/genitourinary-syndrome-of-menopause-gsm-improving-a-dry-topic -
Pregnancy and childbirth have a significant impact on the pelvic floor, often more than patients realize and even more still than most of our current postpartum care models are designed to address. In this episode of the BackTable OBGYN podcast, hosts Dr. Mark Hoffman and Dr. Amy Park welcome Dr. Lisa Hickman, a urogynecologist and pelvic reconstructive surgeon from The Ohio State University, to discuss peripartum pelvic floor disorders and her dedicated clinic for women with advanced obstetric lacerations.
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This podcast is supported by:
PearsonRavitz
https://pearsonravitz.com/backtable
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SYNPOSIS
The conversation touches on key aspects of pelvic floor health, the impact of pregnancy and childbirth, and effective strategies for preventing and managing pelvic floor disorders. The episode emphasizes the importance of patient education, tailored postpartum care, and multidisciplinary collaboration with pelvic floor physical therapists and other healthcare personnel. Dr. Hickman shares insights on building a sustainable clinical model for peripartum pelvic floor disorders, securing stakeholder support, and implementing standardized processes to enhance patient outcomes.
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TIMESTAMPS
00:00 - Introduction
04:21 - Understanding the Pelvic Floor
05:36 - Impact of Pregnancy and Childbirth
07:48 - Preventing and Managing Tears
22:56 - Postpartum Care and Challenges
28:54 - Starting a Peripartum Clinic: A Roadmap
33:54 - Pelvic Floor PT and Patient Education
40:03 - Impact of Repair Techniques on Long-term Outcomes
50:56 - Sustaining and Expanding the Program
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RESOURCES
Hickman LC, Propst K, Swenson CW, Lewicky-Gaupp C. Subspecialty care for peripartum pelvic floor disorders. Am J Obstet Gynecol. 2020 Nov;223(5):709-714. doi: 10.1016/j.ajog.2020.08.015. Epub 2020 Sep 2. PMID: 32888923; PMCID: PMC7720615. -
Thoracic endometriosis occurs in about 12% of patients with advanced endometriosis. Due in part to its lower incidence and inherent diagnostic challenges, many providers are not well-versed in the workup and management of this advanced disease. In this episode of The BackTable OBGYN Podcast, host Dr. Mark Hoffman interviews Dr. Shanti Mohling, a gynecologic surgeon at Northwest Endometriosis and Pelvic Surgery, regarding her approach to thoracic endometriosis.
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CHECK OUT OUR SPONSOR
PearsonRavitz
https://pearsonravitz.com/backtable
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SYNPOSIS
The physicians discuss the embryological and congenital theories of endometriosis etiology, the impacts of retrograde menstruation, and epigenetic factors. Dr. Mohling shares insights into her advanced surgical techniques for treating endometriosis, including diaphragmatic and thoracic disease, and the importance of a comprehensive history, exam, and diagnostic imaging. Her practice patterns, patient care strategies, and interdisciplinary collaborations for optimal outcomes are also highlighted.
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TIMESTAMPS
00:00 - Introduction
06:40 - Pelvic Pain Workup
08:09 - Thoracic Endometriosis
14:12 - Medical Management Post-Surgery
18:48 - In-Office Ultrasound Techniques
23:33 - Collaboration in Surgery
24:59 - Preparing for Thoracic Endometriosis Surgery
36:44 - Managing Postoperative Care
41:13 - Theories on Endometriosis Etiology
46:31 - Concluding Thoughts -
Can cranberry juice prevent UTIs? In this BackTable OBGYN Brief, Dr. Suzette Sutherland and Dr. Anne Cameron discuss various strategies for preventing recurrent UTIs, including which supplements are effective. They cover the efficacy of cranberry supplements, emphasizing the importance of quality and proper compound concentration in products like Ellura. The discussion also addresses the limitations of cranberry juice and the resurgence of methenamine hippurate as a non-antibiotic preventive measure, supported by recent studies. Additionally, they outline comprehensive approaches, including lifestyle modifications, hydration, vaginal estrogen, and hygiene practices, while aiming to destigmatize the condition.
TIMESTAMPS
00:00 - Introduction
00:28 - Cranberry Supplements for UTI Prevention
01:22 - Choosing the Right Cranberry Product
03:05 - Effectiveness and Dosage
05:27 - Cranberry Juice vs. Supplements
06:45 - Exploring Hiprex and Vitamin C
07:08 - Methenamine Hippurate: An Old Medication Revisited
08:59 - Overall Strategy for Managing Recurrent UTIs
11:09 - Vaginal Estrogen
11:48 - Final Thoughts
CHECK OUT THE FULL EPISODE
BackTable OBGYN Ep. 42 - Recurrent UTIs: Controlling Those Nasty Little Bladder Infections
https://www.backtable.com/shows/obgyn/podcasts/42/recurrent-utis-controlling-those-nasty-little-bladder-infections -
Vulvovaginal disorders can be very complex to manage, and many OBGYNs struggle with diagnosis and treatment, especially if topical steroids don’t improve symptoms. In this episode of the BackTable OBGYN Podcast, guest host Dr. Jessica Ritch welcomes Dr. Hope Haefner, a leading expert in women’s health, to discuss diagnosis and management of several vulvovaginal diseases.
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CHECK OUT OUR SPONSOR
PearsonRavitz
https://pearsonravitz.com/backtable
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SYNPOSIS
The discussion covers the importance of accurate diagnosis through physical exams and intake surveys, approaches to pain and symptom management, the significance of vestibulectomy, and the implementation of different treatments for conditions such as vulvodynia, lichen sclerosus, and hidradenitis suppurativa. Dr. Haefner emphasizes the importance of early treatment, the multidisciplinary approach in their clinic, the use of different types of steroids for lichen sclerosus, and innovative treatments and diagnostics. She discusses next-step treatments if common treatments aren’t working, such as the “lichen sclerosus cocktail.” Finally, the episode highlights the need for ongoing professional education and provides resources for further learning.
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TIMESTAMPS
00:00 - Introduction
04:21 - Common Symptoms and Initial Diagnosis
07:19 - Examination and Workup
13:44 - Treatment Approaches for Vulvodynia
20:27 - Managing Lichen Sclerosus
32:27 - Products to Avoid
36:29 - Anoscopy for HPV
40:34 - Addressing Hidradenitis Suppurativa
44:39 - Final Thoughts and Resources
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RESOURCES
Resources for Everything Vulvovaginal Disorder (by Dr. Haefner):
https://www.dropbox.com/sh/r8nhr1j8c19tn9n/AACRLvxGGSgEtZCi6Zzh-yBQa?e=2&dl=0 -
OBGYN Brief - Definition and Diagnosis of a Clinical UTI
Cultures are key when it comes to managing UTIs. In this brief, Dr. Anne Cameron discusses the definitions, symptoms, prevalence, and management of urinary tract infections (UTIs). They delve into the differences between bladder infections and kidney infections, the importance of symptomatology along with bacterial evidence for proper diagnosis, and the higher susceptibility of women to UTIs compared to men. The brief emphasizes the complexities of recurrent UTIs, including the challenges in treatment due to improper antibiotic use, persistence of infection, and anatomical or physiological risk factors. Dr. Cameron also explains the necessity of urine cultures in ensuring effective treatment and the various factors that contribute to recurrent UTIs.
TIMESTAMPS
00:00 - Introduction
00:15 - Definitions and Symptoms of UTIs
01:49 - Prevalence of UTIs in Women and Men
02:44 - Recurrent UTIs: Definitions and Challenges
04:48 - Investigating and Treating Persistent UTIs
CHECK OUT THE FULL EPISODE
BackTable OBGYN Ep. 42 - Recurrent UTIs: Controlling Those Nasty Little Bladder Infections
https://www.backtable.com/shows/obgyn/podcasts/42/recurrent-utis-controlling-those-nasty-little-bladder-infections -
Women’s health has a history of being underfunded in the United States, leading many women to receive suboptimal care. In this episode of the BackTable OBGYN podcast, hosts Dr. Mark Hoffman and Dr. Amy Park engage in a detailed discussion with Dr. Louise P. King, a minimally invasive gynecologic surgeon, and Christopher Robertson, a law professor at Boston University, regarding the inequitable reimbursement structures that persist within the field of OBGYN.
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SYNPOSIS
The guests emphasize the systemic discrepancies between gynecologic and other surgical disciplines. The conversation delves into the origins of these disparities, the complexities of revising current codes and creating new codes, and potential legislative and legal remedies to address gender-based inequities. The guests also stress the importance of patient care outcomes and the role of proper reimbursement in enhancing healthcare delivery.
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TIMESTAMPS
00:00 - Introduction
06:28 - Background on RVUs and Disparities in OBGYN
12:39 - Gender Disparities in Medical Billing
18:00 - Efforts to Address Inequities
31:22 - RUC Structure and Surgical Specialties
32:42 - Billing and Reimbursement Inequities
35:15 - Diagnosis Related Groups
36:42 - Turnover Times and Gender Disparities
40:21 - Advocacy and Legislative Solutions
48:23 - Legal Approaches for Change
52:44 - Conclusion
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RESOURCES
Watson KL, King LP. Double Discrimination, the Pay Gap in Gynecologic Surgery, and Its Association With Quality of Care. Obstet Gynecol. 2021 Apr 1;137(4):657-661. doi: 10.1097/AOG.0000000000004309. PMID: 33706362.
Robertson, Christopher T. and Kupke, Annabel and King, Louise P., Structural Sex Discrimination: Why Gynecology Patients Suffer Avoidable Injuries and What the Law Can Do About It (May 9, 2024). Emory Law Journal, Forthcoming, Boston Univ. School of Law Research Paper Forthcoming, Available at SSRN: https://ssrn.com/abstract=4800783 or http://dx.doi.org/10.2139/ssrn.4800783 -
With contemporary treatment options, your female patients don’t have to live with urinary incontinence! In this crossover episode of BackTable Urology and OBGYN, host Dr. Suzette Sutherland from University of Washington interviews Dr. Sarah Boyles, a urogynecologist at The Oregon Clinic, regarding female urinary incontinence, its diagnostic criteria, and various treatment options to help improve quality of life in the incontinence patient.
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CHECK OUT OUR SPONSOR
PearsonRavitz
https://pearsonravitz.com/backtable
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SYNPOSIS
First, Dr. Boyles explains the importance of patient history and physical examination, along with the need for certain diagnostic tests for proper characterization of the type of urinary incontinence in a patient. She also explores behavioral treatments, pelvic floor physical therapy, vaginal pessaries, and advanced interventions such as urethral bulking and surgery for stress incontinence. The doctors further discuss innovative pharmaceutical and neuromodulation options for urge incontinence.
Dr. Boyles concludes with a mention of patient education resources that are available on her platform, thewomensbladderdoctor.com.
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TIMESTAMPS
00:00 - Introduction
02:35 - The Women’s Bladder Doctor Initiative
07:03 - Types of Urinary Incontinence
11:49 - Diagnostic Approaches to Urinary Incontinence
28:39 - Treatment Algorithms for Urinary Incontinence
31:12 - Bladder Retraining and Pelvic Floor Therapy
40:00 - Urethral Seals and Vaginal Pessaries
50:47 - Treatment for Urgency
57:51 - Future Directions
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RESOURCES
Pearson Ravitz
https://pearsonravitz.com/
The Women’s Bladder Doctor
https://thewomensbladderdoctor.com/ -
Often the first practical thing we’re taught in medical school is the importance of taking a thorough patient history. In this BackTable OBGYN Brief, Dr. Mark Hoffman and Dr. Ted Lee bring us back to the basics and emphasize the importance of conducting a quality patient interview to elucidate symptoms of endometriosis.
The physicians first explore the limitations and practicalities of patient surveys, and move on to discuss the importance of thorough history taking along with specific symptoms to look for. The conversation also delves into the diagnostic challenges and delay of diagnosis in endometriosis patients. They explain the role of surgical diagnosis in endometriosis, emphasizing the necessity of listening to and believing patients’ experiences with chronic pelvic pain.
TIMESTAMPS:
00:00 - Introduction
00:14 - Initial Patient Workup: Surveys and History
01:19 - Key Patient History Indicators
04:24 - Endometriosis Symptoms
07:49 - Treatment Approaches and Surgical Considerations
09:32 - Barriers to Diagnosis
CHECK OUT THE FULL EPISODE
BackTable OBGYN Ep. 30: Ambulatory Workup of Endometriosis Patients
https://www.backtable.com/shows/obgyn/podcasts/30/ambulatory-workup-of-endometriosis-patients -
In the modern era of rapid technological progress and AI, the medical community is abuzz with discussions on how medicine will change and how practice will adapt. In this episode of the BackTable OBGYN podcast, hosts Dr. Mark Hoffman and Dr. Amy Park welcome Dr. Arnold Advincula, a leading figure in minimally invasive and robotic surgery, to discuss the evolution and impact of robotic surgery in the field of gynecology.
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SYNPOSIS
Dr. Advincula shares his journey from training to pioneering robotic-assisted procedures, emphasizing the benefits and challenges faced along the way. The conversation delves into the future of robotics, including the potential of AI in surgery and the integration of digital tools to enhance surgical outcomes. Listeners gain insights into the importance of ergonomic surgery, the advancements in robotic technology, the future of minimally invasive gynecologic surgery, and the collaborative efforts required to elevate patient care in gynecology.
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TIMESTAMPS
00:00 - Introduction
06:05 - Pioneering Robotic Surgery
12:50 - Challenges and Innovations
24:43 - Allure of Robotic Surgery
28:05 - Challenges in Rural Healthcare
35:00 - Future of Minimally Invasive Surgery
42:00 - Advancements in Surgical Training
43:35 - Ergonomics
49:28 - The Future of Gynecologic Surgery
53:06 - Closing Thoughts
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RESOURCES
BackTable OBGYN Ep. 2: Surgeon Ergonomics
https://www.backtable.com/shows/obgyn/podcasts/2/surgeon-ergonomics -
In this BackTable OBGYN Brief, Dr. Mark Hoffman and Dr. Ted Lee discuss the clinical approach to diagnosing endometriosis through physical exam and imaging, and the collaborative surgical approach to treating it.
Dr. Lee explains the importance of detailed patient history and various examination techniques, including palpation and rectovaginal exams, to identify potential signs of endometriosis. He emphasizes the specificity of these exams in differentiating endometriosis pain from other causes. The discussion also covers the role of imaging, such as MRI, particularly in advanced cases, and the collaborative approach with colorectal surgeons for bowel-related complications. Dr. Lee shares insights on the use of physical therapy and managing musculoskeletal pain related to endometriosis, highlighting the importance of multi-disciplinary care for optimal patient outcomes.
TIMESTAMPS
00:00 - Introduction
00:15 - Initial Patient Assessment for Endometriosis
01:00 - Detailed Physical Exam Techniques
07:00 - Imaging and Further Diagnostic Steps
10:55 - Collaborative Surgical Approach
CHECK OUT THE FULL EPISODE
BackTable OBGYN Ep. 30: Ambulatory Workup of Endometriosis Patients
https://www.backtable.com/shows/obgyn/podcasts/30/ambulatory-workup-of-endometriosis-patients -
In this episode of the BackTable OBGYN podcast, host Dr. Mark Hoffman is joined by MIGS specialist Dr. Uchenna Acholonu to discuss the intricacies of complex gynecologic surgeries, focusing particularly on handling large uteruses during total laparoscopic hysterectomy (TLH).
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SYNPOSIS
The discussion begins with talk of the doctors’ practices and friendship. They then cover comprehensive patient evaluations and various surgical techniques, including skeletonizing the uterines, colpotomy tricks, uterine manipulators, and morcellation. Dr. Acholonu also shares his personal routines and preferences, including the use of a flexible scope to get around the big uterus. The duo exchange insights on surgical techniques, patient-centered care, and the continuous learning necessary in the medical field. They emphasize the significance of safety, adequate planning, and the benefits of engaging in community networks for better surgical outcomes. The conversation concludes with a light-hearted note on their shared experiences and camaraderie, offering both educational value and a glimpse into the dynamic relationship between two seasoned professionals.
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TIMESTAMPS
00:00 - Introduction
04:01 - Building a Subspecialty Practice
07:34 - Patient Referrals
12:41 - Surgical Approach
16:06- The Big Uterus
28:36 - Surgical Steps in TLH, Skeletonizing the Uterines
32:56 - Challenges and Solutions
36:49 - Energy Sources and Surgical Tools
42:34 - Colpotomy
44:43 - Tissue Extraction and Morcellation
50:27 - Closing and Post-Operative Care
52:05 - Use of Lupron
53:16 - Final Thoughts -
In this BackTable OBGYN Brief, host Dr. Mark Hoffman interviews Dr. Jan Baekelandt from Belgium about vNOTES (vaginal natural orifice transluminal endoscopic surgery) incision placement to allow future vaginal deliveries and prevent dyspareunia.
First, Dr. Hoffman discusses the nuances of laparoscopy, particularly the preference for smaller incisions to reduce hernia rates and postoperative pain. The conversation covers the specifics of performing colpotomy and the risks associated with different types of incisions, including vaginal and abdominal. Dr. Baekelandt emphasizes the importance of proper training and starting with simpler cases when introducing new surgical techniques like vNOTES.
TIMESTAMPS
00:00 - Introduction
00:32 - Concerns About Hernia Rates and Incisions
01:05 - Vaginal Incisions and Their Implications
02:35 - Vaginal Deliveries After vNOTES
03:55 - Dyspareunia After vNOTES
04:13 - Technical Details on Incision Placement
05:53 - Closing Techniques
06:45 - Advice for Surgeons Introducing vNOTES
CHECK OUT THE FULL EPISODE
BackTable OBGYN Ep 31: The vNOTES Procedure
https://www.backtable.com/shows/obgyn/podcasts/31/the-vnotes-procedure - もっと表示する
