QC Understanding Post-Op Imaging: What It Reveals About Your Endometriosis Surgeon

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0:00

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alana
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time

to

connect
.

Introducing Dr. Abhishek Mingashikar

Speaker 1
0:42

Today

we're

honored

to

have

Dr

Abhishek

Mingashikar

join

us
.

Dr

Ming

is

a

leading

endometriosis

specialist

and

minimally

invasive

gynecological

surgeon

known

for

his

groundbreaking

work

at

Indian

Center

for

Endometriosis

in

Mumbai
.

With

expertise

in

advanced

laparoscopic

and

robotic

surgeries
,

he's

dedicated

to

improving

care

for

those

battling

this

complex

disease
.

Let's

dive

in

and

get

answers

to

the

questions

that

matter

most

to

Post-Op Imaging & Surgeon Skill

Speaker 1
1:07

you
.

How

much

can

post-operative

imaging

reveal

about

a

surgeon's

skill
?

Like
,

for

instance
,

if

images

appear

clean

with

minimal

blood
?

Does

this

indicate

more

of

a

meticulous

surgery
?

Or

rather
,

should

they

focus

solely

on

the

immediate

post-op

imaging
?

Should

patients

prioritize

comprehensive

preoperative

imaging

and

a

surgeon's

thorough

approach

to

excision
,

or

what

role

does

the

post-operative

follow-up

imaging

play

in

assessing

outcomes
,

and

how

does

timing

impact

its

accuracy
?

Speaker 2
1:39

So

there's

a

couple

of

things

that

this

is

a

very

good

question

brings

up

a

couple

of

important

points

of

things
.

That

this

is

a

very

good

question

brings

up

a

couple

of

important

points
.

So

one

is

before

surgery
,

if

your

provider

is

telling

you

I'm

just

going

to

go

in

and

take

the

cyst
,

I'll

be

in

and

out

in

half

an

hour
,

big

red

flag
.

So

an

endometriosis

cyst

never

exists

as

a

single

entity
.

So

there's

always

accompanying

deep

or

peritoneal

disease

along

with

a

cyst
.

So

if

somebody

is

just

planning

to

remove

the

cyst
,

you're

in

trouble
.

The

imaging

is

also

quite

incomplete

if

the

report

of

the

ultrasound

or

the

MRI

comes

back

just

describing

a

cyst
.

So

if

they've

not

picked

up

that

it's

stuck

to

say

the

pelvic

side

wall

or

the

back

of

the

uterus

or

the

uterus

sacral

ligament
,

that's

incomplete

imaging
.

So

they

need

to

do

a

better

level

of

ultrasound

or

MRI
.

Then

the

next

point

is

if

you

should

repeat

imaging

immediately

after

surgery
.

I

don't

think

it's

a

good

idea

to

do

so

immediately

because

you

have

a

lot

of

in

the

immediate

post-op

period
.

There's

a

lot

going

on
,

and

even

in

the

late

post-op

period
,

for

at

least

a

going

on
,

and

even

in

the

late

post-op

period

for

at

least

a

couple

of

months
.

There's

a

lot

of

healing
,

fibrosis
,

whatnot

going

on

inside
.

That

can

confuse

some

of

the

findings
.

I

don't

repeat

imaging
,

at

least

for

six

months

or

so
,

when

they

see

me

at

follow-up

in

general
,

and

I

also

ask

them

to

track

symptoms

during

that

kind

of

recuperative

period
.

So

usually

at

the

end

of

that

period

when

you

do

your

scan

it's

very

important

to

assess

what

was

there

before

versus

what's

there

now
.

Yes
,

some

healing

can

occur

by

fibrosis
.

So

it's

very

important

for

me

as

the

surgeon

to

do

the

imaging

myself

or

at

least

read

the

MRI

myself

or

do

the

ultrasound

Clean Surgery and Adhesion Prevention

Speaker 2
3:23

myself
.

So

I

know

the

areas

that

I've

excised

and

if

I

find

fibrosis

in

an

area
,

I

know

that
,

okay
,

I've

already

excised

that

part

and

yes
,

there

can

be

some

healing

by

fibrosis

there
.

It's

not

really

the

disease

that

was

left

behind

or

a

disease

that

has

grown

back

or

something

like

that
.

Speaker 2
3:39

So

you

were

saying

about

adhesion

prevention
.

So

there's

a

lot

of

talk

about

that

in

surgery

in

general
.

But

endometriosis

is

known

for

adhesions

and

you

know

very

distorted

anatomy
.

So

I

think

one

of

the

main

features

of

adhesion

prevention

is

how

clean

the

surgeon

is
.

So

I

was

discussing

this

with

Shanti

Bowling

a

few

days

ago
.

So

we

were

like

we

both

operate

very

similarly
.

So

we're

very

clean
,

we're

very

meticulous

with

catching

even

like

the

tiniest

bleeders
,

and

I

think

that

plays

a

big

role

not

in

just

the

efficiency

of

your

surgery

but

also

minimizing

adhesions
,

because

the

less

blood

and

oozing

you

have

in

your

surgical

field
,

the

less

adhesions

you're

going

to

form
.

Speaker 2
4:25

And

also

this

comes

about

by

just

dissecting

gently

in

anatomical

spaces
.

You

know

having

a

lot

of

tissue

respect
.

I

watch

a

lot

of

surgery

in

general

because

I

have

no

life

other

than

that
,

and

I

see

some

cases
.

You

know

where

the

surgeons

look

like

they're

just

angry

with

the

tissue

and

you

know

tearing

it

apart
,

trying

to

get

space

in

between

them
.

But

you

have

to

kind

of
.

One

of

the

important

lessons

you

learn

as

a

surgeon

is

like

you

have

to

have

tissue

respect
.

If

you're

kinder

to

it

it's

going

to

kind

of

show

you

the

way

forward

and

I

think

those

are

very

important

roles

in

preventing

adhesions
.

Of

course

it's

very

individualistic
,

so

everybody

heals

differently
.

So

that

also

depends

on

the

body's

tissue

processes

and

reactions

to

insults

of

surgery
.

So

those

are

the

main

things

and

then

of

course

you

have

industry

driven

lesion

prevention

barriers
,

which
,

you

know
,

nobody

knows

how

it

works
,

nobody

knows

what

doesn't
.

We

just

try

them

and

see
.

Speaker 3
5:25

Yeah
,

and

definitely

different

surgeons

have

different

approaches

with

that

and

like

what

they

like

and

you

know

that's

individualized
,

which

is

important

to

talk

to

your

surgeon

if

it's

important

to

you

I

mean

if

that

makes

you

feel

more

confident

in

your

surgery

and

talking

to

them
,

it's

important

to

be

on

the

same

page
.

Speaker 1
5:44

This

Quick

Connect
.

I

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insights

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.

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Episode Closing and Contact Information

Speaker 1
6:08

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