Excision of Endometriosis | Dr. Laurence Orbuch

Endometriosis surgery (Laparoscopic Excision of Endometriosis), performed by an endometriosis specialist, remains the gold standard for both diagnosis and treatment of endometriosis.

Numerous studies have now shown that Excision of Endometriosis lesions is far superior to destructive procedures such as fulguration or laser, especially in DIE (Deep Infiltrating Endometriosis). Unfortunately, most gynecologists are not adequately trained in such advanced endometriosis surgery.

In excision surgery, scissors are utilized to dissect out the endometriosis implants as well as restore the normal anatomy, which is often distorted by the effects of endometriosis. With fulguration or laser, the lesion remains and continues to cause pain necessitating more surgery.

When an Endometriosis surgeon utilizes the laser, the surface of the lesion is addressed but the disease below remains. Adequate surgical excision of endometrial implants provides the best symptomatic relief and long-term results. In addition, surgical excision has been shown to improve fertility rates in women. Drug therapies may suppress endometriosis to a certain degree, but it does not eradicate it.

The definitive treatment of endometriosis is not hysterectomy or removal of ovaries, but rather the complete excision of endometrial implants. Hysterectomy is reserved for patients suffering from diffuse symptomatic Adenomyosis unresponsive to conservative therapy.

da Vinci Excision of Endometriosis

Advantages of Robotic Surgery

Robotic Surgery is an advanced form of Minimally Invasive Surgery. Minimally Invasive endometriosis surgery, which includes laparoscopic surgery, uses small incisions instead of large incisions to perform surgery thus reducing the damage to human tissue.

The da Vinci System is a sophisticated robotic platform designed to expand an endometriosis surgeon’s capabilities. With da Vinci, small incisions are used to introduce miniaturized wristed instruments and a high-definition 3D camera. This allows Dr. Orbuch to view a magnified, high-resolution 3D image of the surgical site allowing for superior visual clarity of anatomy with up to 10x magnification.

At the same time, state of the art robotic and computer technology converts Dr. Orbuch’s hand movements into precise small movements resulting in extreme dexterity. The robotic ‘wrists’ rotate a full 360 degrees that enable Dr. Orbuch to control the miniature surgical instruments with unprecedented accuracy with a wide range of motion.

These technological advancements allow Dr. Orbuch to perform complex surgery with precision, dexterity and control. The da Vinci System enables Dr. Orbuch to perform more precise, advanced techniques and enhances his capability to perform complex minimally invasive surgery.

Robotic Surgery Patient Benefits:

• Less post operative pain
• Less blood loss
• Shorter recovery time
• Less scarring
• Fewer complications
• Quicker recovery and return to normal activities.

Early Clinical Data Suggests that the da Vinci Endometriosis Resection may offer the following potential benefits:

• Ability for endometriosis surgeon to complete difficult dissections (separating of tissue)
• Low rate of complications
• Less blood loss low chance for transfusion
• Low rate of converting to open surgery (through large incision)