da Vinci® Surgery

Endometriosis Treatment in Akron, OH 

Dr. Apostolis is a double board-certified urogynecologist with extensive experience diagnosing and treating endometriosis using minimally invasive techniques.  Dr. Apostolis will take the time to explain your treatment options and answer all of your questions.  Contact Summit Urogynecology at (330) 953-3414 to schedule an appointment in Fairlawn or Youngstown today!

What Is Endometriosis?

Typically, the inner lining of the uterus is shed with each menstrual cycle. Endometriosis is a condition that occurs in women when tissues similar to those of the inner uterine lining start to grow outside of the uterus, behind the uterus, on the bowels, or on the bladder. This results in the appearance of abnormal tissue growth throughout the pelvis, which causes intense pressure and pain in this region of the body. Endometriosis is most commonly diagnosed among women in their 30s and 40s, but the onset of the condition typically starts during standard reproductive years. 

Dr. Costas Apostolis can help diagnose your symptoms and determine the best treatment for you.

Causes & Risk Factors of Endometriosis

There are multiple theories based around the root causes of endometriosis, though there is no known cause at this point in time. It is suggested by scientific evidence that endometriosis may be influenced by one or more of the following factors:

  • Retrograde menstrual flow
  • Genetics
  • A weakened immune system
  • Hormone imbalances
  • Prior surgery of the abdomen or pelvis

Common Symptoms of Endometriosis

The most common symptoms that women experience if they have endometriosis include pain, spotting in between periods, heavy periods, infertility, and digestive problems. Not all women experience each and every one of these symptoms, though a large majority of patients report experiences with pain in some of the following situations:

  • Painful menstrual cramps
  • Chronic pelvic pain in the lower abdomen or intestines
  • Pain during or after sex
  • Painful bowel movements or pain when urinating during menstrual periods

Pain from endometriosis is caused by the abnormal tissues that develop throughout the pelvis. These tissue growths bleed in the same way as the uterus does during a menstrual cycle period, which often leads to extremely painful cramps that tend to worsen over time. Other significant problems can result from a case of endometriosis, such as the fallopian tubes becoming blocked, inflammation occurring, and scar tissue building up around the uterus, intestines, or bladder.

How Is Endometriosis Diagnosed?

In addition to discussing a patient's most various symptoms, Dr. Apostolis may suggest physical exams, imaging tests, or even diagnostic procedures in order to learn more about the patient's current condition and rule out any similar reproductive issues. During a pelvic exam, Dr. Apostolis may be able to feel for large cysts or scars behind your uterus. An ultrasound or MRI may also be done by our team to check for ovarian cysts. Surgery is the only way to confirm whether or not a woman has endometriosis. Dr. Apostolis may perform a laparoscopic procedure to obtain a sample of the endometriosis growths for further review.

Endometriosis Resection Surgery

Learn about endometriosis surgery and understand your options

Take care of you

Endometriosis occurs when tissue that lines the uterus (endometrium) migrates outside the uterus, usually to the area around your reproductive organs, including the ovaries or fallopian tubes. Many women with endometriosis have no symptoms. Although for some women, endometrial tissue patches may swell and bleed with their menstrual cycles, which can cause pain. Endometriosis symptoms may include chronic pelvic pain, heavy menstrual bleeding, pain during sex, pain with bowel movements or urination, and fertility issues.

To diagnose endometriosis, doctors may perform a pelvic exam. However, the only way your doctor can provide a definite endometriosis diagnosis is by performing surgery to locate endometrial patches outside the uterus. Rather than put you through multiple surgeries, your surgeon may remove any endometriosis patches he or she finds while performing diagnostic endometriosis surgery.2

Understanding your options

Your doctor may recommend medication, surgery or both for your endometriosis.1 If you and your doctor decide surgery is right for you, your surgeon will find and remove endometrial patches on and around your ovaries, fallopian tubes, bladder, intestines, and abdomen. 

Surgeons can perform endometriosis surgery using traditional open surgery, which requires a long incision (cut) through your abdominal muscles, or through minimally invasive surgery.

There are two minimally invasive approaches: laparoscopic surgery and robotic-assisted surgery (possibly with da Vinci technology). Both are performed through a few small incisions in the abdomen. To perform a laparoscopic endometriosis procedure, surgeons use special long-handled tools while viewing magnified images from the laparoscope (camera) on a video screen.

How the da Vinci system works

Surgeons can perform robotic-assisted endometriosis surgeries using da Vinci technology. During edometriosis surgery with a da Vinci system, your surgeon sits at a console next to you and operates using tiny, fully wristed instruments.

A camera provides a high-definition, 3D magnified view inside your body. Every hand movement your surgeon makes is translated by the da Vinci system in real time to bend and rotate the instruments with precision.

davinci instruments

It’s important to remember that Intuitive does not provide medical advice. After discussing all options with your doctor, only you and your doctor can determine whether surgery with da Vinci technology is appropriate for your situation. You should always ask your surgeon about his or her training, experience, and patient outcomes.

About da Vinci systems

What are the outcomes of surgery with the da Vinci system? 

Be sure to talk with your surgeon about the surgical outcomes he or she delivers by using the da Vinci system, as every surgeon's experience is different. For example, ask about:

  • Length of hospital stay
  • Complication rate
  • Rate of returning to the hospital within 30 days of surgery 
  • Reoperation rate
  • Transfusion and/or blood loss
  • Chance of changing to an open procedure
  • Length of operation
  • Mortality rate
  • Chance of injury to ureter or colon

There are additional outcomes of surgery that you may want to talk with your doctor about. Please ask him or her about all important outcomes of surgery. All surgery involves risk. You can read more about associated risks of endometriosis resection surgery here

Questions you can ask your doctor

  • What medical and surgical options are available to address my endometriosis?
  • Which is best for me and why?
  • What are the differences between open, laparoscopic, and robotic-assisted surgery? 
  • Should I get a second opinion? 
  • What am I likely to experience after surgery?
  • If I decide to have surgery, how can I prepare for it?
  • Can you tell me about your training and experience with da Vinci robotic-assisted surgery?
  • How will I feel after surgery?

Resources for learning more

Endometriosis surgery brochure

Read this brochure to help enable meaningful and informed conversation with your doctor about different options.

About your options

Gynecologic surgery with the da Vinci system

Gynecology surgeons use robotic-assisted surgery with da Vinci technology in many different types of procedures.

About the specialty

1. Endometriosis. Frequently Asked Questions: Gynecologic Problems. American College of Obstetricians and Gynecologists. Web. 14 May 2020 

2. What are the Treatments for Endometriosis? National Institutes of Health. U.S. Department of Health & Human Services. Web. 14 May 2020 

Disclosures and Important Safety Information

Surgical Risks

Risks associated with endometriosis resection (endometriosis surgery to remove implants) include injury to the bowel, bladder (organ that holds urine) or ureters (the ureters drain urine from the kidney into the bladder).

Important Safety Information

Patients should talk to their doctor to decide if da Vinci surgery is right for them. Patients and doctors should review all available information on non-surgical and surgical options and associated risks in order to make an informed decision. 

Serious complications may occur in any surgery, including da Vinci surgery, up to and including death. Serious risks include, but are not limited to, injury to tissues and organs and conversion to other surgical techniques which could result in a longer operative time and/or increased complications. For Important Safety Information, including surgical risks, indications, and considerations and contraindications for use, please also refer to www.intuitive.com/safety

Individuals' outcomes may depend on a number of factors, including but not limited to patient characteristics, disease characteristics and/or surgeon experience.

Da Vinci Xi System Precaution Statement

The demonstration of safety and effectiveness for the specific procedure(s) discussed in this material was based on evaluation of the device as a surgical tool and did not include evaluation of outcomes related to the treatment of cancer (overall survival, disease-free survival, local recurrence), or treatment of the patient’s underlying disease/condition. Device usage in all surgical procedures should be guided by the clinical judgment of an adequately trained surgeon.

Medical Advice and Locating a Doctor

Patients should talk to their doctor to decide if da Vinci surgery is right for them. Other options may be available and appropriate. Only a doctor can determine whether da Vinci surgery is appropriate for a patient’s situation. Patients and doctors should review all available information on both non-surgical and surgical options in order to make an informed decision.

Surgeons who utilize the da Vinci system can be found using the Surgeon Locator. Intuitive Surgical only provides surgeons with training on the use of the da Vinci system but does not certify, credential, or qualify the surgeons listed in the Surgeon Locator.

Product names are trademarks or registered trademarks of Intuitive Surgical or their respective owners. See www.intuitive.com/trademarks.

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With modern treatments, including minimally invasive surgery, hormone therapy, and other options, we can help alleviate your symptoms and improve your quality of life. Don't wait any longer, schedule a consultation today and take the first step towards reclaiming control of your health and your future.

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If you suspect you may be experiencing symptoms of endometriosis, call (330) 953-3414 to request a consultation with highly trained urogynecologist, Dr. Costas Apostolis, today!

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