Northwest Endometriosis and Pelvic Surgery

02/28/2025

We have a few openings in March to fill!

01/13/2025

Endo. They keep makin’ it, we keep resectin’ it.

01/07/2025

In shameless self promotion of my daughter’s business….

My 11 year daughter Azalea is a talented artist and has launched an Etsy for single line style pet portraits. Only $15 and based on what she’s done so far will be quite good!

Link in first comment.

01/03/2025

The final product. Complete excision with wide margins, the ‘gold standard’ as some like to say.

01/03/2025

Same pelvis, right cul de sac. Lesions like this will cause severe pelvic pain, pain with defecation, and pain with in*******se.

01/03/2025

Endometriosis of the clul-de-sac and right uterosacral ligament in a patient with pain and unexplained infertility.

Not unexplained anymore. Endo is very inflammatory and creates a pelvic environment inhospitable to the egg and / embryo, leading to failed fertilization and implantation. In a patient with intact tubes and healthy ovaries, excision surgery make a big difference in the chance of successful pregnancy.

08/20/2024

I think this is a good reminder that endometriosis can be found outside the pelvis and painfully impact lives. It was an honor to do this podcast and an honor to care for this young woman.

“I'm 31 and feel better than I’ve felt since I was 14. There is hope for you to feel better.” - Camille Dollins[TRIGGER WARNING: Suicidal ideation]✨ Outsmart...

07/08/2024

Surgery is as much art as science. has his Rolling Stones, I have painting my little game figures. This is the last week’s production. I know at least a couple of patients would get a kick out of them.

06/04/2024

Early deep infiltrating endometriosis of the cul-de-sac and uterosacral ligaments. These are quite small, really only a few mm in size, but can still cause a lot of pain and inflammation. If you have a hot coal in your shoe, does it matter how big it is?

05/31/2024

This is what total peritoneal excision of the posterior compartment looks like when it’s done. There is some debate as to whether we should just remove all the peritoneum on endo patients whether it looks normal or not, based on the idea that there could be some small lesions that are not completely visible. Redwine believed that all endo is visible, and maybe thats true, but I have seen positive path on things that were ‘barely abnormal’. My practice had generally been to take wide margins around any lesions I find. In practice, if the lesions are widespread, it ends up being TPE by the time I am happy with the margins.

These sorts of questions are in the art of medicine. It’s very difficult to do a randomized study on the question of TPE vs wide excision. Not impossible, but takes a lot of long term followup which is expensive and difficult, with no industry support most likely.

Sorry haven’t posted much recently - I’ve been sick but am mostly better now. For awhile I had no voice!