Avoid the low volume surgeon

I have just read an interesting article in relation to surgeon volume and outcomes in benign hysterectomy. The data, however, can be extrapolated to other areas of surgery. The thinking behind the concept is not new and was famously discussed in Malcolm Gladwell’s popular book, “Outliers”. He argued that 10,000 hours of deliberate practice is…

The Promotion of Robotic Gynecologic Surgery by US Hospitals: Are Our Patients Being Misled?

The Promotion of Robotic Gynecologic Surgery by Hospitals: Are Our Patients Being Misled?. Medscape. Oct 12, 2012. Hello. I’m Andrew Kaunitz, Professor and Associate Chair of the Department of Obstetrics and Gynecology at the University of Florida College of Medicine in Jacksonville, Florida. Today I’d like to discuss the promotion of robotic gynecologic surgery by…

Scar endometriosis

Over recent months I have seen an unusual number of patients with endometriosis in various scar sites.  The most common situation follows the performance of a caesarian section with a deposit of endometriosis within the operative field.  More rarely and usually without prior surgery (including laparoscopy) the umbilicus can be affected.  Interestingly I have not…

When should the bowel surgeon get involved with endometriosis involving the bowel?

The answer seems simple. The bowel surgeon should be involved early in the process. I agree. The bowel surgeon should ideally have the seen the patient in a pre-operative consultation to discuss the planned procedure, results and potential complications.  The intra-operative timing is the critical thing. If the gynaecologist has minimal surgical skills then invariably…

Dilemmas and controversies in the management of ovarian endometriosis and infertilty

A recent consensus statement on endometriosis and infertility indicates that some women may benefit from a combination of assisted reproduction and surgery.  Unfortunately the data are limited and somewhat conflicting. This is not uncommon when surgery is involved as there is inevitably a degree of operator (or surgeon) dependence. It is self-evident with diseases such…