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

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0:00

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I'm

your

host
,

alana
,

and

it's

time

to

Dr. Mona Arati's Expertise Introduction

Speaker 1
0:37

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

Adhesion Prevention Question Presented

Speaker 1
0:56

.

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

Impact of Adhesions on Women

Speaker 1
1:08

?

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

Surgical Techniques to Prevent Adhesions

Speaker 2
1:30

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

Preserving Fertility and Preventing Pain

Speaker 2
2:20

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

Episode Closing and Contact Information

Speaker 2
3:35

.

Speaker 1
3:35

That's

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