Bowel endometriosis can be treated with minimally invasive surgery, but only by an extremely experienced surgeon. Dr. Seckin believes that endometriosis affects the bowels and associated peritoneum (tissue) covering the pelvic sidewalls, and that the symptoms presented by patients are more specific to those of bowel disorders, and due to this are more likely to have been misdiagnosed as a bowel disorder.
The bowels around the cul-de-sac, particularly around the rectum, are more commonly affected. Clinical presentation of patients with symptoms of constipation, painful sex, painful bowel movements (including rectal pain) and diarrhea – along with an abnormal physical description of their stool and the presence of bloody stools, should immediately alert a doctor that there is an extensive degree of bowel involvement.
Dr. Seckin believes that at the first exam, 80-90 percent of the time an experienced endometriosis doctor can diagnose bowel endometriosis with a vaginal and rectal exam, complemented by a sonogram. Additional tests like MRI and a dual contrast CT scan are necessary to evaluate the condition of the ureters and higher bowel involvement, particularly at the appendix area.
The treatments for bowel endometriosis are either removal of the nodule(s), most of the time including the full thickness of the wall (90%). If the nodules are multiple and obstructive, the treatment is bowel resection surgery. This is particularly difficult and requires special skills in colorectal surgery.
Endometriosis is a multiple organ disease, and because it affects organs other than the reproductive organs, besides the experience and skill of an endometriosis surgeon -- teamwork is necessary. Dr. Seckin works with a surgical team of highly skilled laparoscopic surgeons. The colorectal and urology specialists on his team have unique experience working with Dr. Seckin in the operating room.
In our philosophy of “endometriosis team practice” we have high surgical volume, which is crucial to minimize post-operative complications and increase opportunity for a good outcome. Dr. Seckin strongly believes in increasing the quality of endometriosis surgery by removing the endometriosis from every anatomical location including: bowel, bladder, nerves and the ureters. A margin-free, complete excision without leaving any disease behind is the gold standard that Dr. Seckin practices. It is important to not leave any scar tissue by the unnecessary use of powerful energy sources, like electrofulguration and/or laser, which is associated with incomplete removal of deep disease and complications.
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