– We operate on far more patients with advanced endometriosis than before when hormonal therapy was more common. Last year, a total of 52 patients were operated on, half through robot-assisted peephole surgery and the rest by other methods. This is now being done within the National Highly Specialized Care (NHV) framework, for which Akademiska will be put in charge as one of four hospitals in 2021. In addition, a number of operations for simpler cases of endometriosis have been performed outside the NHV assignment, says Christian Moberg, chief physician. And those responsible for endometriosis care in the academic hospital.
He says the women who had surgery for endometriosis in 2022 mainly came from the healthcare district of central Sweden, but a few also came from other parts of the country.
– This year we operated on the first Ukrainian refugee woman with endometriosis who met the national standard of care for highly specialized endometriosis surgery. “We will see if there is more,” he added.
Endometriosis is a partially genetic gynecological disease with symptoms such as severe menstrual pain, pain during intercourse and going to the toilet, fatigue and lack of energy. Tissue can be found pretty much anywhere in the body; On the ovaries, the area between the uterus and rectum, large and small intestine, cecum, groin, bladder and diaphragm.
In milder cases, painkillers, birth control pills, or the like can be enough to reduce symptoms, but they don’t help everyone. Then you may need to undergo surgery to remove the endometrial changes, usually by peephole surgery. In really severe cases, radical surgery may be necessary, which means completely removing the uterus and ovaries.
In 2009, Academic Hospital was the first in the country to establish a center for endometriosis care, meaning it includes clinics and professions other than doctors and nurses within women’s health care. The Endometriosis Center combines many skills: in addition to gynecologists and oncological surgeons, a midwife, a physiotherapist, a consultant and a pain specialist. The Endometriosis Center is also associated with a colorectal surgeon, radiologist and, if necessary, a urologist.
– Soon a trial will start in Akademika where we will evaluate cryoablation of endometriosis of the abdominal wall after caesarean section as an alternative to traditional abdominal wall surgery, which is a relatively new method in Sweden. This method is minimally invasive and gentle on the patient, says Christian Moberg, with fewer risks of complications.
In short, cryoablation involves freezing tissue with needles so that the endometrium is destroyed rather than an extensive operation with parts of the abdominal muscles removed, reconstruction with mesh implants and the risk of hernia and pain. This method has already been used internationally in the treatment of endometriosis. In the university hospital, it has been used so far, for example, against tumors of the kidneys.
For more information/interview contact:
Christian Moberg, MD, Senior Physician and Endometriosis Care Officer at University Hospital;
[email protected] 0738681496
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