How is Napro Laparoscopic Surgery different from Mainstream?

The removal of ectopic endometrial implants and/or pelvic adhesions helps to optimize fertility and/or to decrease pelvic pain if present.  NaPro surgeons will strive to completely remove ALL ectopic endometrial implants and/or ALL pelvic adhesions, which also reduces the risk of recurrence both. One difference that sets us apart is that our surgeons will use a "Near-contact approach". A high powered camera will be mounted on the end of the laparoscope to allow for visualization of very small endometrial lesions, which will be completely excised. Many mainstream medicine ObGyn surgeons do not believe these very small implants affect fertility, but we have found that they do. When they are removed, our couples do have success in achieving a pregnancy. 

A video recording is made and shared with the couple, which ensures they have an in-depth understanding of their diagnosis and the surgery that was performed. If the endometriosis is extensive. The woman will be scheduled for a subsequent laparoscopy to allow the surgeon to remove all implants. 

Oftentimes, endometrial and endocervical cultures will be taken to assist in the diagnosis and guide further treatment of underlying problems(s) if necessary. Many women who have endometriosis are also found to have a condition called Chronic Endometritis, in which there is a low level "subclinical" infection in the endometrium that is contributing to their infertility or recurrent pregnancy loss. 

Surgeries and procedures performed within the abdominopelvic cavity most often result in the formation of "adhesions" or scar tissue. This is an expected outcome and accepted as unavoidable among mainstream ObGyn surgeons.  Adhesions in the pelvic cavity are well known to cause many problems, themselves, including but not limited to: infertility, pelvic pain, and in some cases blockage of the bowels (intestinal obstruction) which can be a medical emergency. 

NaPro Surgeons are especially trained to use a “Near-Adhesion-Free” surgical technique when performing their surgeries.  They use special delicate instruments and "non-adhesive-producing" suture material.  They neatly close all areas they have surgically cut. Whereas, it is acceptable practice by mainstream surgeons to leave small excised areas unsutured. Additionally, Napro surgeons take extra time to bury the sutures, and oftentimes cover the reproductive organs with an anti-adhesion, absorbable graph, similar to the Gortex graph in the picture, but will naturally be absorbed, so does not have to be removed at a later point in time. 

This protocol has been shown to result in an extremely minimal production of adhesions. Thus, NaPro surgeries are truly "Near-Adhesion Free". 

The NaPro surgeon will reconstruct the uterus, tubes, ovaries and pelvic tissues. The primary goal is to return the damaged organs and tissues to their original, healthy state as much as possible. 

The NaPro surgeon often spends much more time reconstructing the organs and tissues as compared to the time spent excising or lasering ectopic endometrial implants or adhesions.  For this reason, NaPro surgeries are referred to as "Plastic Surgery of Pelvis" or Pelvioplasty". 

Image References: "Pelvioplasty" Lecture presented by Dr. Thomas Hilgers, MD.