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And this is why it is very important to check the appendix during laparoscopy. A diseased appendix can cause pain and appears clubbed and swollen on laparoscopy.

For all our endometriosis procedure, we consent our patients for +/- appendicectomy in view of this and advise removal of appendix if it is found to be diseased

Endometriosis can infiltrate the top part of the va**na and excision of the disease involves a partial vaginectomy. As only a small area is removed, sexual function is not affected.

It was just last year when Mr Khazali started his training in robotic surgery. The team went down to Poole Hospital to learn from Intuitive’s proctor, Mr Jonathan Lippiat

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The majority of fibroids do not cause symptoms but one in four women can experience symptoms depending on the size and location of the fibroid.

Symptoms of uterine fibroids include heavy menstrual bleeding, a feeling of fullness or dragging sensation in the pelvis or urinary frequency.

After surgery, patients can experience symptoms such as inability to pass urine, reduced bladder sensation or inability to completely empty the bladder. All these symptoms are mostly temporary and rarely permanent.

surgery

We want to thank our speakers, Professor Gaby Moawad and Professor Andrew Horne for sharing their interesting work at LEJENDO tonight.

We hope you enjoyed tonight and see you again at our next meeting (6th of March, 6pm UK time)

In a normal pelvis, uterus and both ovaries are free and mobile. In a frozen pelvis, these organs are stuck to each other as well as to the bowel by adhesions caused by endometriosis, thus limiting access into the pelvis.

The next picture represents a frozen pelvis where only the top of the uterus (fundus) is visible, with the sigmoid colon stuck to the back of the uterus. Neither of the ovaries or fallopian tubes are visible.

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The insertion of ureteric stents may be necessary when there is deep endometriosis affecting the ureters.

Endometriosis can cause narrowing or blockage of the ureters and the stents can help relieve this obstruction.

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The answer is no.

The surgical treatment for bowel endometriosis depends on the depth and size of endometriosis infiltration into the bowel.

The surgical treatment for bowel endometriosis is divided into: shave, discoid resection and segmental bowel resection

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Laparoscopic alcohol sclerotherapy has a lesser impact on the ovarian reserve and involves exposing endometrioma to 96% ethanol for 15 minutes to ablate the cyst wall. However, this technique is not suitable for small endometriomas or when the ovaries are not accessible.

Mr Khazali and his most recent fellows: (left to right) Benedetto Mondelli, Shaheen Khazali, Averyl Bachi, Mikey Adamczyk. The CEMIG team have taken home the Karl Storz Golden Telescope four times. This is awarded once a year to the winner of the best surgical video presentation at the British Society of Gynaecology Endoscopy (BSGE).

Women with endometriosis can experience a delay in diagnosis of up to 7 years. Last month, Professor Bendifallah presented his work at LEJENDO which uses saliva to detect microRNA signature for endometriosis. The results are really promising and looking forward to seeing a quick non-invasive diagnostic test available for women. More studies are needed and we are not there yet. We are watching the space.

What is the evidence on dietary intervention in the treatment of endometriosis? This February, we will be discussing this paper published just last year by a team from Switzerland.

Registration is free: https://bit.ly/3YkCTCA
When: 6th February, 6pm (UK time)

Patients with bowel endometriosis can experience symptoms such as pain on opening bowels (dyschezia), pain on sexual in*******se (dyspareunia) and occasionally re**al bleeding. Treatment options include pain medication, hormonal treatment or surgery. If surgery is required, it sometimes needs a surgical team, including a bowel surgeon.

Diaphragmatic endometriosis is a rare form of endometriosis. This February, we have invited Professor Moawad from who will be presenting his paper on the robotic approaches and techniques on the treatment of diaphragmatic endometriosis

Registration is free: https://bit.ly/3YkCTCA
See you on the 6th of February, 6pm (UK time)!

Diaphragmatic endometriosis is a rare form of endometriosis. This February, we have invited Professor Moawad from who will be presenting his paper on the robotic approaches and techniques on the treatment of diaphragmatic endometriosis

Registration is free: https://bit.ly/3YkCTCA
See you on the 6th of February, 6pm (UK time)!

Symptoms of bladder can vary depending on the extent of the endometriosis. Some symptoms may include urinary urgency (when you feel a sudden and very drastic need to pass urine), urinary frequency, and passing urine multiple times at night, also known as nocturia. Some patients might experience painful bladder spasms and even blood in the urine during voiding.

Bladder endometriosis symptoms can easily be mistaken for urinary tract infections. Sometimes even endometriosis growing close to the hypogastric nerves can result in some of the previously mentioned symptoms.

It was lovely to have Dr. Rada, from Romania spend a couple of weeks with us through the European Endometriosis League (EEL) trainee exchange programme.

Bladder Endometriosis refers to endometriosis growing in or around the bladder or bladder peritoneum, also known as the uterovesical space, uterovesical fold or anterior pelvic compartment. It can be superficial or deep and sometimes even grow all the way involving the bladder mucosa. This is known as a full-thickness nodule.
Bladder endometriosis is the most common site of urinary tract endometriosis.

A very encouraging step forward in understanding just published in Nature genetics. We will be inviting the authors to present their work in , Lister Endometriosis journal Club.

http://ow.ly/6EQP50MoEV1

Welcoming Mr. Michael Adamczyk, Consultant Gynaecologist and surgeon to CEMIG London team. Mikey has worked closely with Mr. Khazali for 5 years and has now taken over as his replacement as a substantive Consultant at Ashford & St. Peter's Hospital NHS foundation Trust. He is a very skilled laparoscopic surgeon and shares CEMIG's philosophy of care: evidence-based, patient centres care. He has served on the British Society of Gynaecological endoscopy board since 2018 and is passionate about teaching. He is also one of very few surgeons in the UK with formal training in .