ST. JOSEPH’ S HEALTH
ENDING ENDOMETRIOSIS PAIN
DR. ALI GHOMI
Endometriosis, a chronic condition in which uterine tissue grows outside the uterus, can cause excessive bleeding, bloating and serious discomfort— pain that is emotional as well as physical when the women suffering from it want to become pregnant, and can’ t. It can also be an elusive source of trouble because it is often underor misdiagnosed, and therefore undertreated. The most common symptoms are menstrual abnormalities, and pain during periods in the lower abdomen and pelvic area that is more pronounced than cramping.
Yet for many patients at St. Joseph’ s Health, once the diseased tissue has been removed, the prognosis for pregnancy is good. Dr. Ali Ghomi, who has performed more than 4,000 robotic surgeries and is rated among the top 10 percent of the nation’ s robotic surgeons, performs minimally invasive gynecologic surgery at the St. Joseph’ s Health campus in Wayne, and consults in Totowa at St. Joseph’ s Health’ s Endometriosis and Pelvic Pain Center.
Ghomi takes apatient’ sfull history and prior imaging into account; agood number of his patients have undergone unsuccessful treatments in the past. Depending on the severity of the endometriosis, hemay prescribe suppressing hormones or recommend surgery. On some occasions, says Ghomi, apatient having diagnostic surgery can have her endometrial tissue removed via robotics during the same session, so she won’ t have to come back for asecond surgery.“ In my younger days, when robots weren’ t available, the surgery took two-to-three hours,” says Ghomi.“ These days, Ican do the same procedure in45 minutes.”
Another factor crucial to apatient’ streatment isfollow-up with a pelvic floor physical therapist. Ghomi says that patients who have been living with chronic pain often squeeze their muscles to manage it.“ Those muscles get inflamed, and you need to go through the rehabilitation process to regain muscular function,” hesays. The PTprotocol in this case is typically twice-weekly sessions for three months.
COLUMBIA SURGERY OUTPATIENT OFFICES AT GLENPOINTE
CUTTING-EDGE FETAL SURGERY CONSULTATIONS
Expectant parents in Bergen now have easier access to specialized care for serious fetal conditions. Some patients carrying fetuses with complex developmental abnormalities can now consult pre- and postoperatively in Teaneck with the surgeon who performs these procedures at Columbia / NewYork- Presbyterian in Manhattan.
Dr. Vincent Duron, Co-Director of Fetal Therapy, Surgical Director of the Pediatric ICU, and Director of Minimally Invasive Surgery, now sees patients at the Columbia Surgery Outpatient Offices
DR. VINCENT DURON
at Glenpointe. Heoffers evaluations for fetal surgery, second opinions, and comprehensive follow-up care after surgery.
The fetal patients Duron operates on face serious health risks. One such condition is spina bifida, inwhich the fetal spine doesn’ t fully close, potentially exposing the spinal cord and nerves. This can lead to complications such as paralysis, bowel and bladder dysfunction, and developmental delays. When the fetus reaches 24 to 26 weeks’ gestation— large enough to undergo the procedure— Duron uses afetoscope( asmall camera onathin tube) to perform minimally invasive surgery, making tiny incisions to close the spinal cord.“ We dothis surgery to optimize the outcome for the fetus,” he says.
Another condition he treats iscongenital diaphragmatic hernia( CDH). In these cases, minimally invasive surgery is performed between 27 and 31 weeks’ gestation to repair ahole in the diaphragm( the dome-shaped muscle that separates the chest from the abdomen), preventing internal organs from shifting into the chest cavity. Atechnique called FETO( fetoscopic endoluminal tracheal occlusion), in which aballoon is placed in the fetal trachea totrap lung fluid and stimulate lung growth, is used. Without fetal surgery, babies born with CDH often face serious health challenges and growth delays.
These and other abnormalities can be detected as early as 18 weeks’ gestation, says Duron.
DR. GHOMI: PROVIDED BY ST. JOSEPH’ S HEALTH; DR. DURON: PROVIDED BYCOLUMBIA SURGERY OUTPATIENT OFFICES ATGLENPOINTE
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