Though research into the area of non-invasive diagnosis continues, currently at this time an accurate diagnosis of Endometriosis can only be obtained surgically. Most commonly, this is done via a procedure called the laparoscopy.
Laparoscopy is a Minimally Invasive Surgery (MIS) that currently provides the most accurate diagnosis of endometriosis through the least invasive surgical procedure. Laparoscopic surgery is the most advanced treatment for endometriosis, because it offers permanent removal of the endometriomas and offers the greatest pain relief. This surgery includes the excision of the endometriomas, and the scar tissue and adhesions that develop.
A laparoscopy allows for a doctor to visualize your abdominal-pelvic region via an instrument known as a laparoscope, a thin, lighted instrument that is fitted with a telescopic lens, light sources and a miniature video camera.
During laparoscopy, organs will be manipulated for viewing, biopsies will be taken, the diagnosis of endometriosis will be confirmed, and removal of the disease will be performed.
The surgery begins with a small (approximately ½ inch long) incision being made through the navel, into which a needle is inserted. For better visualization inside the abdominal cavity, carbon dioxide gas is injected into the abdomen through this needle. This colorless, odorless gas distends the abdominal cavity so that the organs will lift and separate to allow the laparoscope to be safely inserted. Additional similar incisions will likely be made in the pubic hairline and/or over the ovaries, through which surgical instruments can be inserted.
Once all the instruments have been strategically inserted, Dr. Seckin will begin to explore the organs and surrounding tissue, take biopsy samples, and then remove the endometriosis and adhesions. These instruments are an extension of the surgeon’s hands, so the best results are obtained when you use the most experienced surgeon.
The first step of laparoscopic surgery is diagnosing. Dr. Seckin will systematically visually evaluate each section inside the abdominal and pelvic cavity. The peritoneum (the lining inside the body) covers the pelvis, bladder, bowel, abdominal cavity, appendix and diaphragm (bottom of the lung). It must be inspected systematically and meticulously for endometriosis, one layer at a time, so that no area is missed.
He will then take biopsies of areas that look suspicious for the disease. A pathologist than examines the tissue and gives the feedback to Dr. Seckin. Tissue is also taken and sent out for more extensive examination.
There are three basic surgical methods that are used today for treating endometriosis and they include: excision, vaporization and ablation.
Excision, which is Dr. Seckin’s method of treatment, involves cutting out the disease while preserving the healthy portions of the affected organs. Wide excision removes all of the endometriosis including the microscopic endometriosis. Studies show this is the most effective surgical means of treating endometriosis and offers the longest symptomatic relief.
Vaporization, often referred to as the EVE Procedure™ stands for Excision and Vaporization of Endometriosis. The procedure involves the destruction of implants by instant boiling of the cellular water with a high-power laser of electrosurgical tool. This procedure is considered superficial and has a high recurrence rate. It often prevents adequate retrieval of tissue samples, due to the destructive nature of the technique. Laparoscopic helium plasma coagulation of endometriosis is another way of vaporizing endometrial deposits. Using a laparoscope, an ionized beam of helium gas is directed at endometrial deposits to destroy the affected tissue. It involves desecration of implants by heating and drying the affected tissue(s). Studies have shown, and Dr. Seckin agrees, that this method has a high recurrence rate for the disease.
Ablation of endometriosis involves burning away the surface of the lesion by using a high-energy heat source; typically, a laser. This should not be confused with the procedure known as endometrial ablation (e.g., Novasure®). Endometrial ablation is performed for the treatment of abnormally heavy bleeding, wherein the endometrium, the thin layer lining the uterus, is destroyed. This lessens or altogether stops the menstrual flow. Endometrial ablation is not a treatment for endometriosis.
Fulguration involves burning away the implants with a spark of electricity from an electrosurgical tool. Again, studies are showing that there is a high recurrence of the disease with this method. In addition to the laser and other surgical tools, some surgeons prefer ultrasonic treatment methods; this means sound waves at very high frequency will be used as the energy source.
Once the surgeon is confident that all procedures have been performed and adequate samples have been taken, all instruments will be withdrawn. The abdomen is deflated and incisions closed, usually with a few dissolvable stitches covered by band-aids. Scarring is generally minor.
I’ve seen many obgyns over the years explaining my monthly symptoms during my period...but eventually it became a daily struggle with these pain. It feels like a poke here and there near my right pelvic region. I was given birth control pills for the past ten years but honestly, it didn’t help at all. I was in bed whenever I had my period. I was previously sent to GI doctors for possible appendicitis but it was ruled out from imagings…
Dr.Seckin is so much more than a surgeon. His passion for helping endometriosis sufferers and determination to improve the quality of life in all of his patients is undeniable. I remember when my gynecologist first told me I needed a laparoscopy. Her exact words were "I can do the surgery, but if you were MY daughter- I'd send you to him." From the first day I met him he took the time to explain endometriosis to me since I knew…
I was there for hysterectomy but then I found out that I also had endometriosis.My both surgeries went excellent and I feel great!.I am so thankful to Dr.Seckin and all his team for making my journey smooth!
I am a physician who suffered from deep infiltrative endometriosis. I needed laparoscopic surgery, so I went to see my former gynaecologist and he performed the procedure (a surgery which he supposedly does hundreds of times a year) last November. I had severe pain again when I had my period in January and was advised to go on taking a low hormone dose anticoncipient pill. My symptoms came back quickly and got worse in a few months’ time. I went…
After years of excessively painful periods, a serious loss of quality of life, and a series of uninformed and uninterested doctors, Dr. Seckin and Dr. Goldstein turned my life around. I was told I woke up from my surgery almost a year ago with a smile on my face, and I haven't stopped since. Before I heard of Dr. Seckin, I was experiencing almost daily terrible pain to the point where I had difficulty walking, inability to eat, inexplicable weight…
Dr Seckin and his team gave me back my life! Tomorrow will be 1 month since my surgery and I feel great. Dr. Seckin, Dr Liu, and Dr Goldstein are not only beyond words talented and amazing Doctors, but they are also genuinely wonderful and caring people. I cannot say enough great things about Holly, Asiye and Kim as well. They were all caring, kind, patient, and took the time to listen to me and explain anything I needed to…
Dr. Seckin and his staff spared me from years and years of heavy periods and unbearable endometriosis pain. After having surgery with him (my first) I can now function like a regular human. No more eating NSAIDs like candy and calling out sick from work. Thank you, Dr. Seckin!