03 May What makes a specialist a “True Specialist” in GYN surgery?
When it comes to GYN surgery, OBGYN’s are not the best option for patients. Why? Because OBGYN’s are really specialists in Obstetrics, not surgery. The average OBGYN dedicates more than 70% of their time and effort on Obstetrics, which is all about the care of pregnant women and delivery of babies. Surgeons perform surgery 100% of the time, not part time, and the OBGYN is really a “part time” surgeon. Part time surgeons do not have the training, patient volume, or full-time focus on surgery to make them proficient enough to learn surgical techniques that provide the best possible outcomes for their patients.
As a result, many OBGYN’s just do not feel “comfortable” doing surgery and will often not do surgery in favor of other less effective options. In many cases these options prolong symptoms such as bleeding, pain, and infertility. Common examples of this are a “watch and wait” approach for fibroids, which allows fibroids to grow and damage the uterus as they become larger over many years. During the waiting, patients have increased pain, heavier bleeding, and can develop anemia and infertility. Endometriosis and a delay in diagnosis OR ineffective treatment can result in severe progressive pain, infertility and ultimately the need for invitro fertilization for pregnancy, which is a time consuming and very expensive process. Some conditions such as Adenomyosis are not diagnosed at all by the OBGYN. This is a common condition, and occurs when the lining of the uterus grows into the muscle and can cause debilitating pain, bleeding, and permanent infertility.
The “True” Specialists
A true “specialist” in GYN surgery is someone who has completed a specialty fellowship in advanced GYN surgery, such as UroGynecology, GYN Oncology, or Minimally Invasive GYN surgery. OBGYN’s that have NOT completed a specialty fellowship, and are calling themselves “laparoscopic specialists”, “endometriosis specialists” or “fibroid specialists” are most often still performing OB as their main focus. GYN surgery is always secondary to these OB’s, and patients have to keep that in mind when identifying who is actually a true specialist, and who is not.
GYN Oncology Training
The highest level of training in GYN surgery is that of a GYN Oncologist. These surgeons have training not just in GYN surgery, but also in the treatment of GYN cancers, which can include surgical management of the bowel, bladder, and ureters. Endometriosis is an example of a condition that “mimics” GYN cancers, in that it spreads and invades “locally” into tissues causing inflammation and pain, and is managed quite well and very effectively using techniques GYN Oncologists use for cancer surgery.
How to Choose the “Right” Specialist for Your Condition
Different surgeons often have areas of “expertise” that they concentrate in. Some fellowship trained Minimally Invasive Surgeons (MIS) focus on endometriosis or fibroids. Others such as UroGynecologists mainly work with patients that have urinary issues such as incontinence or “prolapse” (drop down of the bladder, rectum) due to childbirth. GYN Oncologists focus on complex GYN conditions as their primary source of surgery, often with cancer care also part of what they do.
The Laparoscopically Trained GYN Oncologist
The best trained GYN specialty surgeon is a GYN Oncologist that concentrates on laparoscopic minimally invasive surgery. These surgeons can handle the most complicated cases of fibroids, endometriosis, and adenomyosis, and often OBGYN’s will refer the most complicated patients to these surgeons. Using specialized techniques such as “retroperitoneal dissection”, LAAM fibroid procedures, and DualportGYN for endometriosis and hysterectomy provides patients a superior option for surgical care. Most importantly, these techniques and procedures result in far less pain and complications, and in a fraction of the recovery time compared to robotic or other laparoscopic surgical approaches.
Dr. MacKoul is one of those GYN Oncologists that focuses mainly on very complex GYN cases, and of course can provide care for those patients with general surgical needs. Using refined and specialized techniques with the ability to deal with almost any complication in the pelvis makes this type of GYN Oncologist highly successful in providing the best possible outcomes for endometriosis, fibroids, adenomyosis, and large pelvic masses. Patients treated by this class of surgeon can be assured that outcomes are almost always consistently superior, and complications during surgery with even the most difficult cases are handled effectively.
Dr. MacKoul is always available for discussion of your condition or for a second opinion as needed. Reach out for more information at ……….