QC: Why Do Adhesions Matter In Protecting Fertility and Reducing Pain After Endometriosis Excision?

Dr. Mona Orady breaks down the critical role of adhesion prevention in endometriosis excision surgery—key for protecting fertility and reducing pain. She shares expert techniques, from minimizing tissue trauma to innovative methods like suspending ovaries during healing. Learn how proper surgical strategies, including laser excision, complete hemostasis, and ADEPT solution, help prevent organs from becoming "plastered" together.

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Chapters

• 0:00 Introduction to Quick Connect Format
• 0:37 Dr. Mona Arati's Expertise Introduction
• 0:56 Adhesion Prevention Question Presented
• 1:08 Impact of Adhesions on Women
• 1:30 Surgical Techniques to Prevent Adhesions
• 2:20 Preserving Fertility and Preventing Pain
• 3:35 Episode Closing and Contact Information

Transcript

Speaker 1: 0:00

Life moves fast and so should the answers to your biggest questions. Welcome to EndoBattery's Quick Connect, your direct line to expert insights Short, powerful and right to the point. You send in the questions, I bring in the experts and in just five minutes you get the knowledge you need. No long episodes, no extra time needed, and just remember expert opinions shared here are for general information and not for personalized medical advice. Always consult your provider for your case-specific guidance. Got a question? Send it in and let's quickly get you the answers. I'm your host, alana, and it's time to connect. Today I'm joined by my expert guest, dr Mona Arati of the Arati Women's Clinic, whose expertise in endometriosis and excision, as well as adhesion prevention, is changing the face of endometriosis care. Let's get started. What is the importance in focusing on adhesion prevention for endometriosis and excision surgery, as well as how can providers prevent adhesions from forming and the impact of adhesions on our bodies?

Speaker 2: 1:08

A lot of people don't talk about this but adhesions can have a huge effect on women who are still wanting childbearing. It can affect their fallopian tubes and block their tubes. It can cause pain, it can cause shifting of the uterus and a lot of them already have some adhesions from the endometriosis. And the question is how do we minimize reformation? It would be a whole lecture. I gave a whole hour lecture at SLS about how to all the techniques that I use to minimize adhesions. But to be very brief, number one minimizing the surgery that I do to make sure I only touch what needs to be touched, meaning I don't sit there digging around. I pick up the endometriosis lesions, I excise it using the least amount of energy and the least trauma as possible, even if that means using a laser to actually laser to cut out the lesion. It's less traumatic than using monopolar energy or monopolar scissors. So I use a laser a lot in in endometriosis surgery, using microlaparoscopy when I can, using sharp dis dissection when I can, minimizing tissue trauma, minimizing bleeding because blood can cause adhesions and inflammation.

Speaker 2: 2:11

So my surgeries and everybody else's I don't like to see blood ever. They have to be completely dry, perfectly hemostatic at the end it has to do everything. You rinse everything really clean and then using agents like ADEPT, which is an adhesion prevention solution that coats everything and prevents things from sticking together. It's kind of like a like a syrup that covers everything and kind of coats it so that there's no things don't stick together. It makes everything slippery so that so that you don't develop adhesions.

Speaker 2: 2:39

And then I do procedures where I like I'll elevate the ovaries, ovaries I'll like basically suspend the ovaries away from the area that I dissected or cut out endometriosis for three or four days until that area heals over and then I'll cut the string and release the ovaries so that when they come back down, the fallopian tubes and ovaries were not in the area that's healing, so they don't develop adhesions around them. So there's a lot of techniques that I specifically do and I teach to prevent adhesions, because the majority of my patients and I think the majority of endometriosis patients have not yet had children and you don't want to affect their ability, you want to preserve their fertility and adhesion prevention is a big part of that and it's also a big part of preventing pain and things like that. I've seen patients where I've reoperated on, who had surgery somewhere else or had someone else do surgery, and you go in and it's a complete plastered mess of everything stuck to everything. Well, how is that not hurting? I mean, that's painful just to look at, let alone to actually experience.

Speaker 1: 3:35

That's a wrap for this Quick Connect. I hope today's insights helped you move forward with more clarity and confidence. Do you have more questions with more clarity and confidence? Do you have more questions? Keep them coming, send them in and I'll bring you the expert answers. You can send them in by using the link in the top of the description of this podcast episode, or by emailing contact at endobatterycom or visiting the endobatterycom contact page. Until next time, keep feeling empowered through knowledge.