Patient Information Portal
on Endometriosis -Advanced Endoscopic Surgery -HRT
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Heilig Hart Ziekenhuis
Leopold I straat 45
Prof em Koninckx PR
Dr Koninckx John
Tel : 016 462796 0486 271061
email : pkoninckx@gmail.com
Villa del Rosario
Prof em Koninckx PR
Drssa Ussia Anastasia
Collab : Dr De Cicco Carlo
Tel : +39 348 8605222
email : anastasia.ussia@gmail.com
UK : Mr Enda Mc Veigh
Enda.McVeigh@obs-gyn.ox.ac.uk
Israël : Dr Schonman Ron
ronschonman@gmail.com
(in Belgium), ( Oxford UK ) and (Rome-Italy)
After pioneering endoscopic surgery in Leuven ( Prof Koninckx ), and after teaching for 13 years endoscopic surgery in Oxford as visiting Professor and after 6 years in Rome we founded this international group in order to raise than quality of surgery and in order to train the next generation and for mutual help with very difficult interventions.
Quality surgery means
Laparoscopic surgery is better since less pain, shorter hospitalisation and smaller incicions.
Control of quality needs Videoregistration . A strong indicator of quality is when the surgeon makes a full videoregistration with a copy to the patient.
Few complications. Complications cannot be interpreted without videoregistration.
Less pain and less adhesions result from shorter interventions, with little bleeding and conditioning-cfr EndoSAT NV.
No unnecessary interventions
Alternative treatments should be explained, including those exceeding the skills of the gynecologist.
Few bowel resections for deep endometriosis.
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the literatureis difficult to interpret by non- specialists. Endometriosis is a typical example : more than 20.000 artikels have been published but most of them are clinically irrelevant. What is worse is that hypotheses and speculation often create false expectations.
The information on websites and in the lay press has not been peer reviewed. In addition the information generally is difficult to interpret by zooming in on details without the larger picture (something that is normal in the peer reviewed literature since the reader is supposed to be able to interpret the data ).
Important is the credibility of who is giving information : this can best be judged by his background and publications on a topic. Those who do not do surgery could give very biased information on surgery.
Controversies should be explained Even well performed Randomized Controlled Trials can be interpreted differently. HRT is a typical example. It is useful to understand the background of the controversy and to know what the position is of a doctor.
Correct and complete information are the basis of the Informed Consent which should comprise the diagnosis, the planned surgery, the alternatives and the personal experience and results of the surgeon.
The introduction of endoscopic surgery in gynaecology is still limited. Two examples illustrate this problem. Total laparoscopic hysterectomy (TLH) is standard since more than 10 years ; in Belgium, and the UK and the USA THL still represents less than 10% of all hysterectomies performed. For deep endometriosis, we developed the technique of surgery, and demonstrated that low bowel resections are rarely necessary and contraindicated. Yet more and more segmental rectum resections are performed by lack of training and this nothwithstanding serious side effects.