QC: Pre-Surgical Mapping: The Critical Step Before Endometriosis Surgery

Introduction to Quick Connect

Speaker 1
0:00

Life

moves

fast

and

so

should

the

answers

to

your

biggest

questions
.

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to

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,

alana
,

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it's

time

to

connect
.

Speaker 1
0:41

Today

I'm

joined

by

my

guest
,

dr

Romero

Cabrera
,

who

is

a

distinguished

endometriosis

excision

specialist

based

in

Mexico
,

with

extensive

expertise

in

diagnosis

and

surgical

treatment

of

endometriosis
.

Dr

Ram

has

earned

a

reputation

for

his

innovative

and

patient-centered

approach
.

His

commitment

to

advancing

the

field

of

gynecological

surgery
,

combined

with

his

compassionate

care
,

has

made

him

a

leading

figure

in

the

management

of

endometriosis
.

Dr

Ram's

work

not

only

improves

the

quality

of

life

for

his

patients
,

but

also

contributes

significantly

to

the

global

understanding

of

this

challenging

condition

Prep Starts Now Sponsorship

Speaker 1
1:14

.

You

know
,

one

of

the

things

that

I've

learned

on

this

journey

with

endometriosis

and

chronic

illness

is

that

life

likes

to

throw

curveballs
,

like

medical

kind
,

the

emotional

kind
,

even

the

oh

no
,

the

power's

out

and

the

freezer's

full

of

meal

prep

kind

of

curveballs
,

like

medical

kind
.

The

emotional

kind

even

the

oh

no
,

the

power's

out

and

the

freezer's

full

of

meal

prep

kind

of

curveballs
.

And

if

there's

one

thing

that

keeps

me

grounded
,

it's

being

prepared
.

That's

why

I'm

excited

to

share

something

I

personally

love

Prep

starts

now
.

Speaker 1
1:39

Prep

starts

now

isn't

about

fear
,

it's

about

confidence
.

They

help

you

and

your

family

get

ready

for

anything

natural

disasters
,

power

outages
,

even

medical

emergencies
.

They've

got

tools
,

guides

and

an

amazing

community

to

help

you

feel

secure
,

no

matter

what's

coming

your

way
.

For

me
,

preparedness

is

a

way

to

recharge

life
,

even

with

endometriosis

or

chronic

illness
.

When

I

know

I'm

ready

for

the

what

ifs
,

I

can

focus

on

what's

next
,

and

I

want

that

for

you

too
.

So

here's

the

fun

part

In

preparation

for

getting

prepared

for

surgery

or

for

whatever

life

throws

at

you
.

Speaker 1
2:17

Prepstartsnow

has

given

me

a

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discount

code

just

for

EndoBattery

listeners
.

Use

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at

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Quick

Connect

episodes

powered

up

so

we

can

keep

bringing

you

the

conversations

that

matter
.

So

don't

wait

until

the

unexpected

shows

up

at

your

door
.

Prep

today
,

live

confidently

tomorrow
.

Check

out

prepstartsnowcom

and

remember

prep

really

does

Dr. Romero Explains Surgical Mapping

Speaker 1
2:47

start

now
.

Now

let's

dive

in

to

learning

how

to

prepare

for

surgery

with

surgical

mapping
.

Can

you

explain

to

us

what

is

mapping
?

What

do

you

do

for

mapping
?

Speaker 2
2:58

Of

course

it's

not

something

that

I

create
.

It's

something

that

we

replicate

in

Mexico

and

now

it's

being

replicated

worldwide
.

Mapping

of

the

endometriosis

started

in

Europe
,

in

France

and

in

Italy
.

They

found

out

that

the

radiologists

who

are

used

to

see

the

endometriosis

with

the

special

protocols

because

everyone

in

the

US

have

an

MRI

every

hospital
,

every

hospital

has

the

best

ultrasound
.

I

can

even

assure

you

they

have

the

best

ultrasound

of

the

rest

of

the

world
.

But

the

problem

is

that

the

radiologist

needs

to

go

to

a

learning

curve

to

see

deep

endometriosis
.

But

we

have

to

remember

that

endometriosis

has

to

be

subdivided

in

three

types
.

Something

is

peritoneal
.

This

is

superficial
.

That

is

the

one

that

is

so

little

that

even

sometimes

the

human

eye

cannot

see
.

Deep

endometriosis

is

the

one

that

is

so

little

that

even

sometimes

the

human

eye

cannot

see
.

Deep

endometriosis

is

the

one

that

infiltrates

itself

to

other

organs

and

that's

the

one

we

can

see

through

special

imaging

studies

and

ovarian

endometrioma
.

That

is

the

one

that's

super

easy

to

diagnose

With

a

normal

office

ultrasound
.

You

can

see

the

chocolate

cyst

and

then

we

can

suspect

endometriosis
.

Now

in

Europe

and

France
,

in

Italy
,

they

started

seeing

that

the

radiologists

to

see

this

every

day

have

better

sensibility
.

That

means

that

the

eyes

can

see

better

deep

endometriosis

than

the

normal

radiology

population

and

they

started

to

see

that

if

they

go

before

the

study

to

do

a

rectal

enema

and

when

they

perform

MRIs

they

put

a

rectal

gel
,

a

vaginal

gel

and

some

medication

for

the

bowel

to

not

move
,

then

they

can

see

better

the

disease
.

You

get

me
.

And

with

this
,

without

going

through

surgery
,

they

can

diagnose

if

you

have

endometriosis
,

deep

endometriosis

in

the

bowel
,

in

the

bladder
,

in

the

diaphragm
.

So

with

this

the

surgeon

can

individualize

the

treatment

and

then

get

a

special

team

of

surgeons
.

If

you

have

endometriosis

in

the

diaphoregum
,

then

we

need

a

cardiothoracic

surgeon

and

so

on
.

If

you

have

endometriosis

in

the

bladder
,

a

urinary

surgeon
.

If

you

have

endometriosis

in

the

colorectal

area
,

we

need

a

colorectal

surgeon
.

So

in

Italy

and

France

they

start

doing

something

that

is

a

high

quality

treatment
.

High

quality

treatment

defines

itself

by

doing

a

mapping

of

deep

endometriosis
.

Speaker 2
5:09

The

mapping

of

deep

endometriosis

is

a

specialized

imaging

study

in

which

an

expert

in

radiology

that

has

a

super

long

learning

curve

at

least

five

to

10

years

with

a

specialized

protocol
.

That

means

with

bowel

gel
,

rectal

gel
,

bowel

inhibitory

movement

medication
,

with

an

MRI

or

if

they

are

going

to

do

an

ultrasound
.

It's

not

a

normal

ultrasound
,

I

will

say

to

you
.

It's

an

algorithm

in

which

we

have

to

see

the

african
,

we

have

to

see

the

appendix
,

the

sesum
,

we

have

to

see

the

full

bowel
.

That's

an

abdominal

ultrasound

with

a

bowel

preparation
.

And

then

we

go

to

the

transvaginal

ultrasound

and

see

not

only

the

uterus

and

ovaries

Because
,

remember
,

by

definition

endometriosis

is

outside

the

uterus
.

So

we

have

the

bowel
,

the

bladder
,

the

ureters

and

with

this

a

true

expert

in

imaging

can

send

us

a

classification
,

a

presurgical

classification

that

it's

mandatory

worldwide
.

It's

called

the

ANC

classification

In

the

US

they

are

still

doing

something

that

it's

an

association

for

Reproductive

Society

of

Medicine

classification

that

divides

the

disease

in

stages
,

stage

one

to

stage

four
.

Speaker 2
6:18

Right

now

that

classification

is

really

old
.

Speaker 2
6:21

It's

the

one

that

my

father

used

to

use
,

because

if

they

go

under

surgery

and

they

classify

you

with

a

stage

four
,

like

they

did

with

my

sister
,

my

sister

will

tell

you

oh
,

thank

you

very

much
,

but

that

doesn't

mean

anything
.

That

means

that

I

have

in

every

place
.

With

the

NCM

protocol

we

can

do

the

classification

before

Specialized Imaging and Classification Protocols

Speaker 2
6:41

surgery
.

That's

mandatory

and

with

this

we

can

see

if

the

disease

is

affecting

the

intestine
,

the

bladder

or

other

organs
,

and

not

only

see

if

it's

affecting
,

we

can

also

see

the

size

of

the

nodule
,

the

length
,

the

percentage

of

bowel

affection
.

So

with

this

we

can

plan

the

surgery

before

going

in
,

because

we'll

never

do

again

a

laparoscopic

diagnosis

surgery

without

the

mapping

If

they

are

going

to

do

a

laparoscopic

surgery
.

The

human

eye

cannot

see

through

tissue
,

so

if

they

enter

and

see

everything

attached

to

itself

like

a

frozen

pelvis
,

no

surgeon
,

no

surgeon

worldwide
,

even

the

best

surgeon

in

the

world
,

even

myself
,

if

I

go

without

a

mapping
,

I

cannot

see

the

nodule

because

I

can

only

see

the

superficial

layers

of

the

organs
.

Speaker 1
7:28

Now

that

we've

talked

about

pre-surgical

mapping

and

empowered

you

with

the

knowledge

to

make

the

best

decision

for

your

health
,

let's

talk

about

something

that's

just

as

important

comfort
,

because

if

surgery

is

in

your

future
,

comfort

is

key
.

But

let's

be

honest
,

that

doesn't

mean

we

have

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.

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8:40

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.

I

hope

today's

insights

helped

you

move

forward

with

more

clarity

and

confidence
.

Do

you

have

more

questions
?

Keep

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coming
.

Send

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Episode Wrap-up and Contact Information

Speaker 1
9:20

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Until

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,

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