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Endo Explained: Ask The Experts (ep. 3)

Join us for ep. 3 of Endo Explained: Ask the Experts taking place on Saturday, June 27th at 10am PST/1pm EST!
This month, we’ll be covering all of your questions on bowel endometriosis.


This month our panel of bowel endometriosis experts will include:

 

Dr. Camran Nezhat

Camran Nezhat, M.D. has been called the father of modern-day surgery for inventing and pioneering video surgery.(1-10) His developments have revolutionized surgery and gradually have replaced laparotomy. He and his team have been the first to perform many of the most advanced laparoscopic surgical procedures with and without robotic-arm assistance.(1-56) Early on he advocated (11,12) and proved that the majority of the open procedures of the time could be performed via videolaparoscopy. (1-56) By doing so, he opened the door for surgeons all over the world to advance the field of minimally invasive surgery and help their patients. (1-53)

As the original proponent for minimally invasive surgery, he has declared that wherever in the body a cavity exists or can be created minimally invasive surgery is possible and probably preferable, the limiting factors are the skill and experience of the surgeon and the availability of proper instrumentations. (11-12)

In the 1990’s he collaborated with robotic pioneers Ajit Shah and Phil Green on development of the daVinci Robot (52) and has innovated many of its applications. (13, 50-55) Following the pioneering work in video-laparoscopy, Camran Nezhat and his collaborators have been credited with performing the following procedures for the first time in surgical history:

GYNECOLOGY

● Laparoscopic treatment of extensive endometriosis involving multiple organs 1985-1986,1988- 1989, 1991-1994 (4, 12-16, 18, 30-38)

● Laparoscopic removal of dermoid cyst 1989 (17)

● Radical hysterectomy with paraaortic and pelvic node dissection 1989-1992 (12,18-20)

● Operative laparoscopy during advanced pregnancy 1990-1991 (21)

● Management of ovarian remnant 1991-1992 (23)

● Sacral colpopexy 1992, 1994 (12,24)

● Laparoscopic-assisted myomectomy 1994 (25)

● Laparoscopic repair of vesico vaginal fistulas 1994 (26)

● Vaginal cuff dehiscence following laparoscopic hysterectomy 1995-1996 (27)

● Laparoscopic debulking for advanced ovarian cancer 1996 (28)

● Laparoscopic repair of Cesarean scar defect (Niche, Isthmocele, Diverticulum repair.) 2003 (29)

COLORECTAL

● Laparoscopic bowel resection (including shaving technique, disk excision, and segmental colon resection by natural orifice, mini laparotomy, and total laparoscopic approach) 1988-1992, 1994 (12,14,18,30-38)

UROLOGY

● Ureter resection 1990, 1992 (39,40)

● Bladder resection 1992 (41)

● Ureteroneocystostomy with and without Psoas Hitch 1992, 1999 (39,40,42)

● Vesico vaginal fistula repair 1994 (26)

UPPER ABDOMEN AND CHEST

● Diaphragm resection and repair 1992 (43)

● Laparoscopic treatment of lung endometriosis 1992, 2012 (44,45)

● Laparoscopic treatment of liver endometriosis 2005 (46)

VASCULAR

● Laparoscopic repair of major retroperitoneal vessels 1997, 2002 (47,48)

The pioneering work above, along with his other innovations, like vessel sealing and cutting devices, suction irrigation instruments, surgical lasers, safe abdominal entry techniques, robotics, etc., serve millions of patients around the world. He has more than 30 patents for his various inventions and developments.

He is the author of eight textbooks and several hundred peer reviewed articles and book chapters. He has trained many physicians around the world who have become pillars of their communities. He started teaching postgraduate courses in 1982 and continues to teach and share his knowledge with medical professionals internationally. He has had teaching and leadership roles at many different societies and universities around the world.

In 2014, Camran Nezhat in collaboration with Society of Laparoscopic and Robotic Surgeons, started the first “Endometriosis Specialist” Subspecialty in Minimally Invasive and Robotic Surgery Fellowship, embracing a multidisciplinary approach. He is the Founder of Worldwide Endometriosis March (EndoMarch), a global grassroots movement with the mission of raising awareness about endometriosis and finding noninvasive diagnostic testing, and ultimately, prevention and treatment (www.endomarch.org). More than sixty countries are involved in this movement. He is the recipient of many awards. He has been involved in research, teaching, innovating and philanthropic activities while in private practice throughout his professional life. His biggest love is to take care of his patients.

For more information, please visit www.nezhat.org.

Contact:
Click here to request an appointment
650-327-8778
office@camrannezhatinstitute.com

 

Dr. Louise King

Louise P. King, MD, JD, is an Assistant Professor of Obstetrics, Gynecology and Reproductive Biology at Harvard Medical School and a Surgeon within the Division of Minimally Invasive Gynecologic Surgery at Beth Israel Deaconess Medical Center. Dr. King completed her juris doctorate at Tulane Law School before attending medical school at University of Texas Southwestern Medical Center. She completed her residency in obstetrics and gynecology at Parkland Hospital in Dallas Texas and her fellowship in Minimally Invasive Surgery with Dr. Camran Nezhat at Stanford University. Her areas of interest in medical ethics focus on questions of informed decision making and assisted reproduction.

 

Dr. Michelle Nisolle

Professor M NISOLLE was graduated doctor in medicine, surgery and deliveries in 1983 and obtained her Ph.D Thesis in 1996 on the topic of endometriosis.
She is presently Professor of Gynaecology at the University of Liege in Belgium and head of the university department of Obstetrics and Gynaecology at the “Hôpital de la Citadelle” in Liege.

She is especially involved in endoscopic surgery and also in robotic surgery for benign conditions. She is also involved in the surgical teaching of fellows.

She is the academic secretary at the board of the Group of Gynecologists Obstetricians of French Language of Belgium (GGOLFB). She is a faculty member of the European Society of Human Reproduction and Embryology (ESHRE) and a member of the Steering Committee for the Special Interest Group Endometriosis/Endometrium (Deputy for Endometriosis). She is chairwoman of the Special Interest Group “Reproductive Surgery” at the European Society for Gynaecological Endoscopy (ESGE).

She is also a member of many international societies and reviewer of several International Journals. Her research is focused primarily on endometriosis and in particular on the physiopathogenesis of endometriosis. The second theme of her research concerns the ovarian cryopreservation.
She has created, with the help of STORZ Company, the Endoscopic Training Centre (ETCL) at the University of Liege in order to allow the continuous training of fellows in obstetrics and gynecology, and to facilitate courses on cadavers.
She is author and co‐author of 130 chapters of Books, 207 publications in national and international Journals.

 

 

Dr. Marion Schertzer

Dr. Marion E. Schertzer graduated magna cum laude from Queens College in New York. She received her medical degree from Southwestern Medical School in Dallas, Texas and completed her general surgery residency at the Cleveland Clinic in Ohio. Dr. Schertzer joined Georgia Colon & Rectal Surgical Associates in August 1993 after completing a fellowship in colon and rectal surgery at the University of Texas in Houston.

Dr. Schertzer is board-certified by the American Board of Surgery and the American Board of Colon & Rectal Surgery. She is an active member of the Medical Association of Georgia, Atlanta Women’s Medical Alliance, American Society of Colon and Rectal Surgeons and the Piedmont Medical Society. Dr. Schertzer is past Chairperson of the Medical Advisory Committee with the Crohn’s & Colitis Foundation Georgia Chapter and a fellow at the American College of Surgeons and The American Society of Colon and Rectal Surgeons.

 

Dr. Farr Nezhat

Dr. Farr Nezhat, a board-certified gynecologic oncologist and Medical Director of Nezhat Surgery for Gynecology/Oncology, is a pioneer and leading authority in the minimally invasive surgical treatment of malignant and benign gynecologic pathologies. He welcomes patients at two locations: New York, New York, on the upper east side of Manhattan, and Valley Stream, New York, in Nassau County, Long Island.

His medical practice is a referral center for patients seeking treatment for gynecological cancers and complex benign conditions. His expertise lies in treating ovarian, uterine and cervical cancers; as well as severe and multi-organ endometriosis, pelvic masses, ovarian cysts and uterine fibroids.

He is a clinical professor of obstetrics and gynecology who contributes prolifically to the scientific and medical literature, a frequent director of postgraduate courses, and a regularly invited faculty member at professional societies and congresses. His research and educational endeavors have earned him worldwide recognition.

Contact:
Manhattan office: 646-970-2737
Long Island office: 516-663-1365
Website – www.farrnezhatmd.com

 

Dr. Ceana Nezhat

Ceana Nezhat, MD is a world renowned gynecological surgeon and medical director of Nezhat Medical Center, Medical Director of Education & Training and Director of Minimally Invasive Surgery & Robotics at Northside Hospital in Atlanta, Georgia, Adjunct Professor of Gynecology and Obstetrics at Emory University School of Medicine, and Editor in Chief of the Atlanta Medicine journal. He has developed techniques and refined instrumentation for minimally invasive surgical treatment of severe and multi organ endometriosis, infertility, and urologic and pelvic reconstruction. Dr. Nezhat offers patients decades of gynecological expertise, both surgically, as well as the management and treatment of hormone therapy and reproductive medicine. Dr. Nezhat’s innovative research and educational outreach have earned him prestigious honors and recognition from independent medical associations internationally. Dr. Nezhat has coauthored several textbooks and over 100 book chapters and articles. He is a member of many distinguished societies, reviewer for several academic journals, and advisor to teaching organizations.

Contact:
Click here to request an appointment
404-255-8778
Website – www.nezhat.com

 

Dr. Azadeh Nezhat

Dr. Azadeh Nezhat is co-director of the Center for Special Minimally Invasive and Robotic Surgery and performs surgery at the Stanford University Medical Center, in Palo Alto, California. She graduated with a Bachelor’s Degree from Georgia Institute of Technology, received her Doctorate from the Medical College of Georgia, and then completed her Residency from the University of Illinois, Chicago. Before joining Dr. Camran Nezhat, she spent 11 successful years practicing Obstetrics and Gynecology as a Partner of Roswell OB/GYN, an affiliate of Atlanta Women’s Health Group, on which she is a Board member. Her special interest is endometriosis and myoma of the uterus, using minimally invasive and robotic techniques. She also has a special interest regarding the effects of endometriosis in young girls. She is also the co-founder of the Worldwide Endometriosis March and Endometriosis day.

Contact:
Click here to request an appointment
650-327-8778
office@camrannezhatinstitute.com

1) Podratz, Karl, MD PHD. Degrees of Freedom: Advances in Gynecological and Obstetrical Surgery. Remembering Milestones and Achievements in Surgery: Inspiring Quality for a Hundred Years 1913-2012. Published by American College of Surgeons 2012. Tampa: Faircount Media Group; 2013.
2) Kelley WE. The Evolution of Laparoscopy and the Revolution in Surgery in the Decade of the 1990s. JSLS : Journal of the Society of Laparoendoscopic Surgeons. 2008;12(4):351-357.
3) Tokunaga R. Video surgery expands its scope. Stanfor Med 1993/1994: 11(2);12-16
4) Stanford News Services Media Monitor. Stanford Report. February 9, 2005; 9.
5) Carter JE. Biography of CamranNezhat, MD, FACOG, FACS. JSLS : Journal of the Society of Laparoendoscopic Surgeons. 2006;10(2):275- 280.
6) Page B. Camran Nezhat the Advent of Advanced Operative Video-laparoscopy. In: Nezhat C, ed. Nezhat’s History of Endoscopy. Endo Press, Tuttlingen, Germany. 2011: 159-187
7) Baker, Sherry. “A Dozen Atlanta ‘Super Doctor’.” Atlanta Magazine, Nov. 1984.
8) Wallis, Claudia. “Medicine: The Career Woman’s Disease?” Time Magazine, 28 Apr. 1986.
9) Clark, Matt. “Conquering Endometriosis. Lasers battle ‘the career women’s disease’.” Newsweek. 13 Oct. 1986; 95.
10) Cowley Geoffrey. “Hanging up the knife. A novel surgical technique promises to save patients time, money and blood.” Newsweek. February 12, 1990; 58 –59.
11) Nezhat, C., Crowgey, S. R. & Garrison, C. P. Surgical treatment of endometriosis vialaser laparoscopy. Fertility & Sterility. P 45, 778 — 783. (1986)
12) Nezhat, C, Nezhat F, Nezhat C, Operative laparoscopy (minimally invasive surgery). State of the art, J Gynecol Surg. 1992; 8:111–141.
13) Nezhat C, Saberi NS, Shahmohamady B, Nezhat F. Robotic-assisted laparoscopy in gynecological surgery JSLS. Vol 10 (3), p 317 — 320. (2006)
14) Nezhat C, Nezhat F. Evaluation of safety of videolaseroscopic treatment of bowel endometriosis, Scientific Paper, 44th Annual Meeting of the American Fertility Society, Atlanta Hilton and Towers, Atlanta, Georgia, October 8 — 13, 1988
15) Nezhat C, Hood J, Winer W, et al. Videolaseroscopy and laser laparoscopy in gynecology. Br J Hosp Med. P 38, 219 — 224. (1987)
16) Nezhat C, Videolaseroscopy: a new modality for the treatment of diseases of the reproductive organs. Colposc Gynecol Laser Surg 1986; 2: 221 – 224
17) Nezhat C, Winer WK, Nezhat F. Laparoscopic removal of dermoid cysts. Obstet Gynecol, February 1989;73(2): 278 — 281.
18) Nezhat C, Nezhat F. Silfen SL. Videolaseroscopy: the CO2 laser for advanced operative laparoscopy. Obstet Gynecol Clin North Am. 1991;18:585–604.
19) Nezhat C, Burrell M, Nezhat F, Benigno B, Welander CE. Laparoscopic radical hysterectomy with paraaortic and pelvic node dissection. Am J Obstet Gynecol. 1992;166:864–865.
20) Nezhat CR, Nezhat FR, Ramirez CE, et al. Laparoscopic radical hysterectomy and laparoscopic assisted vaginal radical hysterectomy with pelvic and paraaortic node dissection, J Gynecol Surg. 1993;9:105–120.
21) Nezhat F, Nezhat C, Silfen S, Fehnel S. Laparoscopic Ovarian cystectomy during pregnancy. J Laparoendosc Surg. 1991;1:161–164.
22) Nezhat C. Letter to the Editor: Radical Hysterectomy. Am J Obstet Gynecol, May 1993;168(5): 1643-1644.
23) Nezhat F, Nezhat C. Operative laparoscopy for the treatment of ovarian remnant syndrome. Fertil Steril, May 1992;57(5): 1003 – – 1007.
24) Nezhat F, Nezhat C, Nezhat CH. Laparoscopic sacral colpopexy for vaginal wall prolapse. Obstet Gynecol. 1994;84:885– 888.
25) Nezhat C, Nezhat F, Bess O, Nezhat CH, Mashiach R. Laparoscopically assisted myomectomy: a report of a new technique in 57 cases. Int J Fertil Menopausal Stud. P 39(1): 39 — 44. (1994)
26) Nezhat CH, Nezhat F, Nezhat C, Rottenberg H. Laparoscopic repair of a vesicovaginal fistula: a case report. Obstet Gynecol. 1994;83:899 – 901.
27) Nezhat CH, Nezhat F, Seidman DS, Nezhat C. Vaginal vault evisceration after total laparoscopic hysterectomy. Obstet Gynecol 1996;87: 868–870.
28) Amara DP, Nezhat C, Teng NN, Nezhat F, Nezhat C, Rosati M. Operative laparoscopy in the management of ovarian cancer. Surgical Laparoscopy 1996 Endoscopy & Percutaneous Techniques. P 6(1): 38 — 45. (1996)
29) Jacobson M, Osias J, Velasco A, Charles R, Nezhat C. Laparoscopic repair of a uteroperitoneal fistula. JSLS. 2003;7:367–369.
30) Nezhat CR, Nezhat FR. Safe laser excision and vaporization of endometriosis. Fertil Steril, 1989; P 52(1): 149 – 151
31) Nezhat C, Pennington E, Nezhat F, Silfen SL. Laparoscopically assisted anterior rectal wall resection and reanastomosis for deeply infiltrating endometriosis. Surg Laparosc Endosc, June 1991;1(2): 106 — 108.
32) Nezhat F, Nezhat C, Pennington E. Laparoscopic proctectomy for infiltrating endometriosis of the rectum. Fertil Steril, May 1992;57(5): 1129-1132.
33) Nezhat F, Nezhat C, Pennington E, Ambroze W Jr. Laparoscopic segmental resection for infiltrating endometriosis of the recto sigmoid colon: a preliminary report. Surg Laparosc Endosc. 1992;2:212–216.
34) Nezhat C, Nezhat F, Pennington E. Laparoscopic treatment of lower colorectal and infiltrating rectovaginal septum endometriosis by the technique of videolaseroscopy. Br J Obstet Gynae- col. 1992;99:664–667.
35) Nezhat C, Nezhat F, Nezhat CH. Surgery for Endometriosis of the Bowel, Bladder, Ureter, and Diaphragm. Annals of the New York Academy of Sciences, 1997; 828: 332-340
36) Nezhat C, Nezhat F, Pennington E, et al. Laparoscopic disk excision and primary repair of the anterior rectal wall for the treatment of full thickness bowel endometriosis. Surg Endosc. 1994;8:682– 685.
37) Nezhat C., Nezhat F. Ambroze W. & Pennington E. Laparoscopic repair of small bowel and colon: A report of 26 cases. Surg Endosc. P 7(2): 88 – 8 9. (1993)
38) Nezhat F. Triumphs and controversies in laparoscopy: the past, the present, and the future. JSLS. 2003;7:1–5.
39) Nezhat C, Nezhat F, Green B. Laparoscopic treatment of obstructed ureter due to endometriosis by resection and ureteroureterostomy. A case report. J Urol. 1992;148:865–868.
40) Nezhat CH, Nezhat F, Freiha F, Nezhat C. Laparoscopic vesicopsoas hitch for infiltrative ureteral endometriosis. Fertil Steril. 1999;71:376– 379.
41) Nezhat C, Nezhat F. Laparoscopic segmental bladder resection for endometriosis: a report of two cases. Obstet Gynecol. 1993;81:882– 884.
42) Nezhat CH, Malik S, Nezhat F, Nezhat C. Laparoscopic ureteroneocystostomy and vesicopsoas hitch for infiltrative endometriosis. JSLS. 2004;8:3–7.
43) Nezhat F, Nezhat C, Levy JS. Laparoscopic treatment of symptomatic diaphragmatic endometriosis: A case report. Fertil Steril. 1992;58:614–616.
44) Nezhat C, King LP, Paka C, Odegaard J, Beygui R. Bilateral thoracic endometriosis affecting the lung and diaphragm. JSLS. 2012 Jan-Mar; 16(1): 140–142
45) Nezhat C, Main J, Paka C, Nezhat A, Beygui R. Multidisciplinary Treatment for Thoracic and Abdominopelvic Endometriosis. JSLS. 2014 Jul-Sep; 18(3)
46) Nezhat C, Kazerooni T, Berker B, LaShay N, Susan Fernan- dez S, Marziali M. Laparoscopic management of hepatic endometriosis: report of Two Cases and review of literature. J Min Invas Gynecol. 2005;12:196–200.
47) Nezhat C, Childers J, Nezhat F, et al. Major retroperitoneal vascular injury during laparoscopic surgery. Hum Reprod. 1997; 12:480 – 483.
48) Jacobson M, Oesterling S, Milki A, Nezhat CR. Laparoscopic control of a leaking inferior mesenteric vessel secondary to trocar injury. JSLS. 2002;6:389–391.
49) Nezhat F, Nezhat C, Allan CJ, Metzger DA, Sears DL. Clinical and histologic classification of endometriomas: implications for a mechanism of pathogenesis. J Repro Med. 1992;37:771–776
50) Nezhat C, Lavie O, Hsu S, Watson J, Barnett O, Lemyre M. Robotic-assisted laparoscopic myomectomy compared with standard laparoscopic myomectomy — a retrospective matched control study. Fertility and Sterility Vol. 91 (2), p 556 — 565. (2009)
51) Nezhat C, Hajhosseini B, King LP. Robotic-assisted laparoscopic treatment of bowel, bladder, and ureteral endometriosis. JSLS. 2011 Jul-Sep; 15(3):387–392
52) Shah A, Schipper E. Robot-Assisted Laparoscopy. In: Nezhat C, Nezhat F, Nezhat CH, editors. Nezhat’s Video-Assisted and Robotic- Assisted Laparoscopy and Hysteroscopy. New York: Cambridge University Press; 2013: 628-632.
53) Nezhat CR, Lewis M, Kotikela S, Veeraswamy A, Saadat L, Hajhosseini B, Nezhat CH. Robotic Versus Standard Laparoscopy for the Treatment of Endometriosis. Fertility and Sterility, (2010) Feb-Dec, Volume 94, Issue 7, P 2758 — 2760.
54) Nezhat C, Lavie O, Lemyre M, Gemer O, Bhagan L, Nezhat CH. Laparoscopic hysterectomy with and without a robot: Stanford experience. JSLS. 2009 Apr-Jun; 13(2): 125–128)
55) Nezhat C, Lavie O, Lemyre M, Unal E, Nezhat CH, Nezhat FR. Robotic-Assisted Laparoscopic Surgery in Gynecology: Scientific Dream or Reality? Fertility and Sterility, Volume 91, Issue 6, P 2620 — 2622, (2008).
56) Nezhat C, My Journey with AAGL. Journal of Minimally Invasive Gynecology. 2010; 17(3): 271-277. 57) Nezhat C. Operative endoscopy will replace almost all open procedures. JSLS. 2004;8:101–102.
58) Nezhat C. 2005 Presidential address. JSLS. 2005; 9:370-375
59) Nezhat C, Nezhat F. Laparoscopic Repair of Ureter Resected During operative Laparoscopy. Obstet Gynecol. September 1992; 80(3 Pt 2): 543-544.
60) Nezhat C, Nezhat F, Nezhat CH. Nezhat’s Operative Gynecologic Laparoscopy and Hysteroscopy.Cambridge: Cambridge University Press, New York, NY. 4th edition. 2013.

 

Some other early reports, by Drs. Camran, Farr, and Ceana Nezhat, in peer reviewed journals

  •  Nezhat C, Nezhat F, Silfen SL. Laparoscopic hysterectomy and bilateral salpingo-oophorectomy using multifire GIA surgical stapler. J Gynecol Surg, 1990;6: 287-288.
  •  Nezhat F, Winer WK, Nezhat, C. Fimbrioscopy and salpingoscopy in patients with minimal to moderate pelvic endometriosis. Obstetrics and Gynecology. P 75(1): 15 — 17. (1990)
  •  Nezhat F, Nezhat C, Gordon S, Wilkins E. Laparoscopic versus abdominal hysterectomy. J Reprod Med, March 1992;37(3): 247 – – 250.
  • Nezhat, F., Nezhat, C., Welander, C. E. & Benigno, B. Four ovarian cancers diagnosed during laparoscopic management of 1011 women with adnexal masses. American journal of obstetrics and gynecology 167, 790 — 796 (1992).
  •  Nezhat C, Nezhat F, Burrell M. Laparoscopically assisted hysterectomy for the management of borderline ovarian tumor: A case report. J Laparoendosc Surg, Aug 1992; 2(4): 167-169
  • Nezhat F, Nezhat C, Bess O, Nezhat CH. Laparoscopic amputation of a noncommunicating rudimentary horn after a hysteroscopic diagnosis: a case study. Surg Laparosc & Endosc. P 4(2):155 — 156. (1994)
  • Nezhat CH, Bastidas A, Pennington E, Nezhat F, Raga F, Nezhat C. Laparoscopic treatment of type IV rectovaginal fistula . J of Am Assoc. of Gyn Lap, Vol. 5, No. 3, Pp: 297 — 299, August 1998.