The gold standard for both diagnosis and treatment of endometriosis is excision of the disease. Unfortunately, this can only be done with surgery. This means there is no perfect blood test or imaging study that can detect with 100% certainty endometriosis is present. With deep-stage disease you can have a strong suspicion based on imaging (ultrasound or MRI) but it is proven with biopsy.
Surgery requires the insertion of a small camera inside the belly button to look down into the abdomen and pelvis while you are asleep with general anesthesia. Don’t worry you won’t feel it!
Additional small incisions are made 2-3 (less than 1cm in length) in order to place the precision instruments. This allows Dr. Karli Provost Goldstein and the team of specialists and assistants to insert the instruments and use them to excise lesions down to the millimeter. Early-stage endometriosis is often only 1-2mm in size and requires visualization with a camera zoomed in. Some lesions may appear white or clear in early stages and require careful inspection.
Dr. Karli Provost Goldstein completed a 3 year fellowship in advanced laparoscopy in endometriosis excision. She completed over 1000 cases and over 16,000 excisions of endometriosis during her training. She was also specially recognized by the American Board of Obstetrics and Gynecology as a high-volume minimally invasive gynecologic surgeon.
Whether robotic or advanced laparoscopic she is committed to ensuring you have the best minimally invasive surgery with precision technique and deep endometriosis excision while preserving your fertility or organs desired.
She specializes in coming up with a customized approach for each patient after a thorough consultation of their history and fertility and health goals. In this way, there are hopefully no surprises or unintended loss of organ or function after the surgery.
Photos and videos can be provided of your pelvis and endometriosis and each specimen is removed entirely and sent to the expert pathologists to examine for endometrial glands or stroma/ inflammation/scar tissue or cancer.
The pathologic examination under the microscope usually comes back within a week and Dr Goldstein will review in depth the results with you and what it means.
Each of your symptoms is important in creating a map of where your disease could be sitting! The best thing you can do for your surgeon is write down exactly where the pain and symptoms occur and what times of the cycle these occur.
At ESSE Care and Wellness, we are committed to providing you with world-class excision of endometriosis with a highly trained team of experts.
