Known for his expertise,
chosen for his care.

CLINICAL ASSOCIATE PROFESSOR MICHAEL COOPER OAM

MBBS, FRANZCOG, FRCOG, MHKCOG

Clinical Associate Professor Michael Cooper is one of the doctors recognised in the 2018 Queen’s Birthday Honours List. He was awarded the Medal of the Order of Australia in the General Division for his service to medicine in the field of gynaecology. The award is a testament to A/Prof. Cooper’s dedication to his profession, his commitment to his patients and communities to improve women’t health and the lives of those suffering from endometriosis in all its manifestations.

ABOUT A/PROF. MICHAEL COOPER

Clinical Associate Professor Michael Cooper OAM is a gynaecologist in private practice in Sydney. His major interest is in the treatment of endometriosis particularly requiring advanced surgical and/or assisted reproductive techniques (IVF).

He is currently the Head of Gynaecology at both Royal Prince Alfred Hospital and St. Luke’s Hospital and a Visiting Medical Officer to Royal Prince Alfred Hospital, St Luke’s Hospital and St Vincent’s Private Hospital. He is also an accredited doctor with Genea to provide a complete range of fertility and genetic services.

In addition to his private practice and his role as the Head of Gynaecology at RPAH and St Luke’s Hospital, A/Prof. Cooper is kept busy with regular training of specialist surgeons and students at endoscopic surgery workshops, undertaking research and speaking at national and international conferences. He initiated one of the early endoscopic training centres for gynaecologists in Australia and is part of SWEC team that provides training to specialist surgeons. He is the author of over 50 peer-reviewed medical journal publications and book chapters published in Australia and globally. Known for his expertise as an accredited Advanced Level Endoscopic Surgeon, A/Prof. Cooper has been an invited surgeon to many hospitals in Australia and Asia and currently operates in Hong Kong on an occasional basis.

Healthcare provider, educator, researcher.
Life changer.

He was previously a Board Member of the Australian Gynaecological Endoscopy Society and a member of the Scientific Committee of the International Society for Gynaecological Endoscopy. He served as an advisor to the World Heath Organisation on research and training in gynaecological endoscopic surgery and has performed over 3000 advanced laparoscopic procedures including excision of endometriosis, hysterectomy, colposuspension, pelvic floor reconstruction and lymph node dissection.

A/Prof. Cooper’s multidisciplinary background allows him to provide a patient centred, continuing, comprehensive care that meets patients individual needs without having to transition between specialists. The continuity of care helps patient to cope better with the challenges of endometriosis and fertility treatment by reducing stress and eliminating waiting time.

With more than two decades of experience in the field adding to his already substantial surgical skills, A/Prof. Cooper has developed a multidimensional evidence-based approach to endometriosis and fertility treatment. He often encourages patients to make simple positive lifestyle changes which can assist in managing the symptoms thus, empowering them to take control and live well with endometriosis.

SURGICAL EXPERIENCE

The following table includes all major procedures since 1995. Some minor procedures have been omitted. Since the database has been running A/Prof Cooper has performed about 97% of operations without a large abdominal incision.

Click link below to read commentary on these results

SURGICAL COMMENTARY

Commentary on Procedures and Complications to end of May 2017.

The tables display all procedures and major complications to the end of May 2017. It should be noted that considerable care should be taken when interpreting these numbers. Associate Professor Cooper operates on a large number of patients with significant endometriosis and the risk profile of this group of patients for complications is higher than the general population. Secondly he may not be aware of some complications and as such these figures may under represent the true numbers.

Since commencing practice as a specialist gynaecologist in 1995 Associate Professor Cooper has undertaken over 10,000 operative procedures. He has performed over 5,500 laparoscopies most being of an operative rather than a diagnostic nature. Over the last 10-15 years his practice has predominantly moved towards endometriosis and he has performed over 1,500 interventions for the excision of endometriosis. Of these at the time of writing 388 have had bowel resections of various forms of being performed. These procedures represent the most difficult and complex of gynaecological surgery including cancer. The significant complications and issues are listed in the table.

There were 3 significant vascular complications all of which were treated by immediate laparotomy and oversewing of various vessels.

Fourteen patients required laparotomy to deal with some form of issue involving the bowel. There was an overall colostomy rate of 12 with a rate of 0.2% of all laparoscopies. Ten of the stomas related to patients with endometriosis and 6 of these were planned intra-operatively with a rate of 0.36% per endometriosis patient. Four unplanned stomas were performed in the post operative period at a rate of 0.24% Two patients who had procedures unrelated to endometriosis required stomas with an overall rate of 0.04%. An additional patient with endometriosis had a recto-vaginal fistula which healed spontaneously (0.02%).

Three patients required laparotomy for bladder injuries (0.05%) and of these 1 patient had endometriosis (0.06%).

Twelve patients required some form of intervention in relation to the ureter. All of these patients had endometriosis as an underlying condition. Delayed recognition of the injury occurred in 2 patients (0.12%) and 10 required some form of intra-operative repair or stent. Five stents were placed as prophylaxis to ensure against a possible leak in the post operative period.

Twenty nine patients had to return to theatre with an overall rate of 0.28%. These included the 3 bladder and 4 bowel patients mentioned above. Other issues included 7 post operative bleeds, 7 abscesses and infected areas, 2 patients who ultimately had no abnormality detected, 1 patient with a small bowel obstruction following a bowel resection, 1 omental herniation at a trocar site, 1 perforation at a hysteroscopic myomectomy, a vault dehiscence in a patient who initiated sexual activity in the early post operative period following a hysterectomy, a recurrent Bartholin’s abscess and 1 patient who had a microscopic needle identified in the recovery room following laparoscopic tubal reversal with a needle which had initially been counted as outside the patient.

There were no patient deaths. The overall major complication rate was 0.36% (38/10423). The rate per laparoscopy was 0.64% (35/5487). Specifically for endometriosis cases the rate was 0.78% (13/1674).

Associate Professor Cooper believes this complication profile is appropriate for the type of surgery he performs and is happy to discuss this analysis.
Commentary on Procedures and Complications to end of May 2017.

The tables display all procedures and major complications to the end of May 2017. It should be noted that considerable care should be taken when interpreting these numbers. Associate Professor Cooper operates on a large number of patients with significant endometriosis and the risk profile of this group of patients for complications is higher than the general population. Secondly he may not be aware of some complications and as such these figures may under represent the true numbers.

Since commencing practice as a specialist gynaecologist in 1995 Associate Professor Cooper has undertaken over 10,000 operative procedures. He has performed over 5,500 laparoscopies most being of an operative rather than a diagnostic nature. Over the last 10-15 years his practice has predominantly moved towards endometriosis and he has performed over 1,500 interventions for the excision of endometriosis. Of these at the time of writing 388 have had bowel resections of various forms of being performed. These procedures represent the most difficult and complex of gynaecological surgery including cancer. The significant complications and issues are listed in the table.

There were 3 significant vascular complications all of which were treated by immediate laparotomy and oversewing of various vessels.

Fourteen patients required laparotomy to deal with some form of issue involving the bowel. There was an overall colostomy rate of 12 with a rate of 0.2% of all laparoscopies. Ten of the stomas related to patients with endometriosis and 6 of these were planned intra-operatively with a rate of 0.36% per endometriosis patient. Four unplanned stomas were performed in the post operative period at a rate of 0.24% Two patients who had procedures unrelated to endometriosis required stomas with an overall rate of 0.04%. An additional patient with endometriosis had a recto-vaginal fistula which healed spontaneously (0.02%).

Three patients required laparotomy for bladder injuries (0.05%) and of these 1 patient had endometriosis (0.06%).

Twelve patients required some form of intervention in relation to the ureter. All of these patients had endometriosis as an underlying condition. Delayed recognition of the injury occurred in 2 patients (0.12%) and 10 required some form of intra-operative repair or stent. Five stents were placed as prophylaxis to ensure against a possible leak in the post operative period.

Twenty nine patients had to return to theatre with an overall rate of 0.28%. These included the 3 bladder and 4 bowel patients mentioned above. Other issues included 7 post operative bleeds, 7 abscesses and infected areas, 2 patients who ultimately had no abnormality detected, 1 patient with a small bowel obstruction following a bowel resection, 1 omental herniation at a trocar site, 1 perforation at a hysteroscopic myomectomy, a vault dehiscence in a patient who initiated sexual activity in the early post operative period following a hysterectomy, a recurrent Bartholin’s abscess and 1 patient who had a microscopic needle identified in the recovery room following laparoscopic tubal reversal with a needle which had initially been counted as outside the patient.

There were no patient deaths. The overall major complication rate was 0.36% (38/10423). The rate per laparoscopy was 0.64% (35/5487). Specifically for endometriosis cases the rate was 0.78% (13/1674).

Associate Professor Cooper believes this complication profile is appropriate for the type of surgery he performs and is happy to discuss this analysis.

The following results are current as at end March 2017:

Procedure

Number

%

Total excision of endometriosis 1674
Including endometrioma (ovarian chocolate cyst) 419 23
Incuding bowel resection 388 25
Unplanned repeat endometriosis surgery 137 9
No endometriosis found 50 3
Endometriosis present at repeat surgery 87 6
Repeat surgery for endometrioma (cyst) recurrence  (%/initial endometrioma) 28 2
Overall hysterectomy  (endometriosis patients) 106 7

ENDOMETRIOSIS SURGERY RESULTS

Number

Severe 693
Moderate 646
Mild 335
Bowel Resection 388

TOTAL

1674

Procedure

Number

%

Operative Laparoscopy 5030 48
Diagnostic Laparoscopy 457 4
Excision of Endometriosis 1674 16
Major Vaginal 656 6
Abdominal 153 2
Bowel Resection 388 4

Total

10423 100

Please note that the above results should be interpreted with caution. It is possible that the reoperation rates reflects a lower number than reality as some patients may have had repeat surgery of which A/Prof Cooper is not aware.