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Endometriosis Surgery and Adhesion Prevention Nicholas Leyland,  BASc , MD,MHCM, FRCSC   Chief of OB/GYN St Joseph’s Health Centre, Medical Director of Women’s, Children’s and  Family Health Program. Associate Professor OB/GYN, University of Toronto. Left  Ureterolysis
*Trademark ©ETHICON, INC. 2007
Interceed: ,[object Object],[object Object],[object Object]
 
Surgical Approach: Objectives ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Is Surgery Even Necessary? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Indication for Surgical Management of Endometriosis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Surgery Pros and Cons ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Macroscopic appearance of endometriosis black, red, vesicular  POD obliteration  Marked distorted anatomy Endometriotic cysts Adhesions Bowel endometriosis
Additional Limitations of Surgery ,[object Object],[object Object],[object Object],[object Object],[object Object]
SURGICAL OPTIONS: EXCISION OR ABLATION? For Endometriosis
Surgical Options: Excision vs. Ablation ,[object Object],[object Object],[object Object],[object Object]
Surgical Options:    “to cut or not to cut” ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
DOES SURGERY HELP? Endometriosis Related Pain
Does Surgery Help Pain? ,[object Object],[object Object],[object Object],[object Object],[object Object]
Does Surgery Help Pain? ,[object Object],[object Object],Laparoscopic surgery for pelvic pain associated with endometriosis (Cochrane Review 2008) Jacobson TZ, Barlow DH, Garry R, Koninckx P
Ablation versus Excision ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Additional Surgical Skills for Advanced Endometriosis Surgery ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Deeply infiltrating endometriosis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Deep Versus Superficial Endometriosis: What do you see?
Ovarian Endometriomas
Ovarian Endometriomas ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Endometriomas ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Endometriomas ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Ablation versus Excision of Cysts ,[object Object],[object Object],[object Object],[object Object]
ADJUNCTIVE SURGICAL TECHNIQUES
Additional Surgical Options ,[object Object],[object Object],[object Object],[object Object]
Appendectomy:  “The Hockey Stick” Sign
Adhesions: ,[object Object],[object Object],[object Object]
Arrhythmia Management Arrhythmia Management **Circulatory_Disease_Management** **Circulatory_Disease_Management** General Surgery General Surgery **Laboratory_Medicine** **Laboratory_Medicine** Neurosurgery Neurosurgery Nursing Nursing **Ob_Gyn** **Ob_Gyn** Orthopaedics Orthopaedics                                                    HOME     REGISTER     LOGIN     HELP     PRIVACY POLICY                               Advanced Search       Product Information          Professional Resources          Product Ordering          Contact Us                                                    More Information  GYNECARE INTERCEED (TC7) Absorbable Adhesion Barrier   Essential Product Information       GYNECARE INTERCEED (TC7) Absorbable Adhesion Barrier  Clinical Information       Clinical Bibliography        Incidence of Post-Surgical Adhesions  Features and Benefits       Proven Effective and Safe  Order Information       Order GYNECARE INTERCEED (TC7) Absorbable Adhesion Barrier  Company Home Page       ETHICON Women's Health & Urology, a division of ETHICON, INC.  Related Product Information       GYNECARE INTERCEED (TC7) Absorbable Adhesion Barrier                                                                                                                                                                                                                                                                          Post-surgical Adhesions—A common & costly outcome                                                                                                                                                            Despite even the best surgical techniques, post-surgical adhesions form in the majority of patients undergoing gynecologic pelvic surgery          Adhesions following some gynecologic surgery are a major cause of post-operative pelvic pain, infertility, bowel obstruction and the need for repeat surgery 6          It is impossible to predict who will develop adhesions or where they will occur           In addition to the emotional cost to the patient, post-surgical adhesions cost the U.S. healthcare system $1.6 billion annually 7            Adhesion barriers are a proven method of enhancing good surgical technique in reducing post-surgical adhesions        *Trademark  ©ETHICON, INC. 2007 All contents copyright © Johnson & Johnson Gateway, LLC 2000-2009 unless otherwise noted. This site was written for U.S. healthcare professionals only. Click here for our  Privacy Policy  and  Legal Notice . If you have chosen this country and/or language view in error and need to return to the main menu  click here . Capitalized product names are trademarks of Johnson & Johnson or its affiliated companies. Prescription products or in vitro diagnostics only unless otherwise noted in our  non-prescription product list .  
Interceed: ,[object Object],[object Object],[object Object]
 
 
 
 
 
TAKE HOME MESSAGES
Take Home Messages: ,[object Object],[object Object],[object Object],[object Object],[object Object]
Take Home Messages ,[object Object],[object Object],[object Object],[object Object]
Approach to Managing Endometriosis: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Surgical Approach: Objectives ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
THANK YOU!
 

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Endometriosis Talk

  • 1.  
  • 2. Endometriosis Surgery and Adhesion Prevention Nicholas Leyland, BASc , MD,MHCM, FRCSC Chief of OB/GYN St Joseph’s Health Centre, Medical Director of Women’s, Children’s and Family Health Program. Associate Professor OB/GYN, University of Toronto. Left Ureterolysis
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  • 10. Macroscopic appearance of endometriosis black, red, vesicular POD obliteration Marked distorted anatomy Endometriotic cysts Adhesions Bowel endometriosis
  • 11.
  • 12. SURGICAL OPTIONS: EXCISION OR ABLATION? For Endometriosis
  • 13.
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  • 15. DOES SURGERY HELP? Endometriosis Related Pain
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  • 21. Deep Versus Superficial Endometriosis: What do you see?
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  • 29. Appendectomy: “The Hockey Stick” Sign
  • 30.
  • 31. Arrhythmia Management Arrhythmia Management **Circulatory_Disease_Management** **Circulatory_Disease_Management** General Surgery General Surgery **Laboratory_Medicine** **Laboratory_Medicine** Neurosurgery Neurosurgery Nursing Nursing **Ob_Gyn** **Ob_Gyn** Orthopaedics Orthopaedics                                                 HOME    REGISTER    LOGIN    HELP    PRIVACY POLICY                             Advanced Search     Product Information        Professional Resources        Product Ordering        Contact Us                                                More Information GYNECARE INTERCEED (TC7) Absorbable Adhesion Barrier Essential Product Information     GYNECARE INTERCEED (TC7) Absorbable Adhesion Barrier Clinical Information     Clinical Bibliography     Incidence of Post-Surgical Adhesions Features and Benefits     Proven Effective and Safe Order Information     Order GYNECARE INTERCEED (TC7) Absorbable Adhesion Barrier Company Home Page     ETHICON Women's Health & Urology, a division of ETHICON, INC. Related Product Information     GYNECARE INTERCEED (TC7) Absorbable Adhesion Barrier                                                                                                                                                                                                                                                                        Post-surgical Adhesions—A common & costly outcome                                                                                                                                                      Despite even the best surgical techniques, post-surgical adhesions form in the majority of patients undergoing gynecologic pelvic surgery          Adhesions following some gynecologic surgery are a major cause of post-operative pelvic pain, infertility, bowel obstruction and the need for repeat surgery 6          It is impossible to predict who will develop adhesions or where they will occur          In addition to the emotional cost to the patient, post-surgical adhesions cost the U.S. healthcare system $1.6 billion annually 7          Adhesion barriers are a proven method of enhancing good surgical technique in reducing post-surgical adhesions        *Trademark ©ETHICON, INC. 2007 All contents copyright © Johnson & Johnson Gateway, LLC 2000-2009 unless otherwise noted. This site was written for U.S. healthcare professionals only. Click here for our Privacy Policy and Legal Notice . If you have chosen this country and/or language view in error and need to return to the main menu click here . Capitalized product names are trademarks of Johnson & Johnson or its affiliated companies. Prescription products or in vitro diagnostics only unless otherwise noted in our non-prescription product list .  
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