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The list  on Endozone.org  “Where endometriosis patients find surgeons & solutions”   is misleading and not helpful for patients, at least for Belgium. .

First since solutions and surgeons are mixed,  it does not help the patient to find a surgeon.  This is clearly so for Belgium since it lists at least 2 gynecologists,  1  who was forbidden to do surgery now 13 years ago by his institution and 1 who is no longer practicing.

Second, the list seems to be self-declared  since I was unable to find the criterions to be listed .   If not self-declared the question arises  who is  responsible for the  listing,  for  inaccuracies and for completeness.

The list does not help a patient to find a surgeon, nor his skills or expertise,  since this cannot be identified from the list. Thus the risks are real   of seeing a gynecologist who is not a surgeon and the risk of postponing surgery and getting hormone therapy for a long period, or the risk of having incomplete surgery because of lack of skills for deep endometriosis, or having an unnecessary bowel resection for deep endometriosis instead of a discoid excision.  The latter is a debated topic with many so-called scientific arguments, often ending with the magic word “individualization”. The reality, however, is that some groups almost systematically perform bowel resections while others perform bowel resection in less than 5%.

The list – if complete- might be useful if used as suggested before. ‘https://www.gynsurgery.org

–          After identifying a gynecologist the patient should turn to pubmed  (https://www.ncbi.nlm.nih.gov/pubmed/)  and enter “ name-of-gynecologist  AND endometriosis”  to have a list of publications. From the list of publications it is apparent whether this gynecologist is performing deep endometriosis surgery, whether he/she performs  discoid excision or systematically bowel resections, or whether only superficial endometriosis is treated, or whether no surgery is performed. If no publications are listed and the gynecologist is not very young, he still might be a good surgeon but he probably is not an authority in the field of endometriosis.
- Publications however do not necessarily reflect technical skills. Therefore it might be useful to ‘google’ the name of the gynecologist in order to get a flavour of his presentations and live surgery. Again, if no presentations or live surgery are found and the gynecologist is not young, he still might be a good surgeon but he probably is not a surgical authority in the field of endometriosis recognized by his peers .

–          Before being operated the patient should ask 2 simple questions to the gynecologist.  First “what is your experience and what are your results (not those of the literature) “  and second,  “are you willing to make a video-registration of the entire intervention and give me a copy afterwards”.  This is a simple way to identify those gynecologist who are experienced and feel more secure.

Prof em Philippe R. Koninckx  and Drssa Anastasia Ussia
Gruppo Italo belga for advanced endometriosis surgery
Leuven Belgium and Rome Italy

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