Patient Information
on Endometriosis -Advanced Endoscopic Surgery -HRT
Documents
from Belgium (KULeuven), Oxford-UK ( OLS) and Rome-Italy ( Gruppo Italo-Belga)
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 tha quality of surgery and in order to train the next generation and for mutual help with very difficult interventions .
De literature pubmed is 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The information on websites and in the lay press has not been peer reviewed.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 (somthing that is normal in the peer reviewed literature since the reader is supposed to be able to interpret the data ).
Inportant 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 Randomised 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.