I was recently asked to complete a survey into the “pain of laparoscopic surgery”. The authors were interested in the pain experienced by surgeons who perform laparoscopic surgery. This started me thinking about a subject that I have often discussed with trainee surgeons under my care; that is the ergonomics of laparoscopic surgery. For those…
DetailsOur new paper just published on this topic. Management of deeply infiltrating endometriosis involving the rectum. CE Koh, K Juszczyk, MJ Cooper, and MJ Solomon Dis Colon Rectum, September 1, 2012; 55(9): 925-31. BACKGROUND: Rectal endometriosis can cause debilitating symptoms. Rectal resection in this setting has been shown to improve symptoms; however, there remain…
DetailsA recent media report of ovarian transplantation with subsequent infertile women conceiving has raised great interest at a conference in Istanbul. (“Ovary transplant breakthrough lets women gives birth in older age – SMH – 5 July 2012”). 28 babies were born to infertile women who had ovarian tissue transplanted. I have heard the lead surgeon, Dr…
DetailsPremenstrual spotting is an important characteristic sign of endometriosis. It usually takes the form of dark or brown staining or spotting lasting more than 12 hours prior to menstruation beginning normally. This association has been known about for some time but has not been well appreciated by doctors or gynaecologists. There appears to be…
DetailsOver the last few years I have travelled to Hong Kong and China to operate and run surgical workshops where I have had the honour of teaching and working with other specialist gynaecological surgeons. I am registered as a specialist gynaecologist in Hong Kong and have been accredited to operate as an advanced level laparoscopic…
DetailsA reasonable part of my practice involves the use of IVF to assist couples in their quest to conceive. Clearly, however, the underlying issues and reasons why IVF are required should be elucidated and dealt with before proceeding to IVF. Recent times in Australia have seen the proliferation of a large number of IVF units…
DetailsA recent report published in Lancet Oncology has raised again the possibility that endometriosis and certain types of ovarian cancer may be closely linked. The authors admit that further analysis is required although suggest that people should consider ongoing surveillance. Unfortunately there are significant problems with the data particularly the patient recollection of a…
DetailsI had a fascinating discussion with a dentist recently in relation to gum disease (periodontal disease) and other chronic inflammatory diseases. Several research studies have associated gum disease with other chronic inflammatory diseases such as diabetes, cardiovascular disease, rheumatoid arthritis and now possibly endometriosis. There are various grades of severity of periodontal disease and…
DetailsSynarel and Zoladex are similar agents both acting at the level of the brain to suppress ovarian function and thus elicit a menopausal type status. The resulting low oestrogenic state does have some temporary benefits in relation to the suppression of endometriosis. The problem however is that for many people the menopausal type symptoms are…
DetailsI have just returned from the United States and have had the opportunity to discuss healthcare systems with a number of gynaecologists there. Having had these conversations and others over the years with other gynaecologists having a similar practice it strikes me that whilst the US is good in the main part for many people…
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