Dr. Theodoros Kapetanakis, MD
Endometriosis Specialist
Summary:
Dr. Theodoros Kapetanakis is a board-certified obstetrician-gynecologist and endometriosis specialist based in West Hartford, Connecticut. He practices with Hartford HealthCare Medical Group and is affiliated with Hartford Hospital and Manchester Memorial Hospital. He completed fellowship training in Advanced Endometriosis Care and Minimally Invasive Gynecologic Surgery at Mount Auburn Hospital, where he subsequently served as Director of the Endometriosis and Advanced Pelvic Surgery/MIGS Fellowship from 2023 to 2025.
Dr. Kapetanakis’s philosophy of endometriosis care is informed by Müllerian and modern genetic and epigenetic theories of the disease. He emphasizes thorough excision during the initial surgery, followed by individualized aftercare through pelvic floor physical therapy and pain management. His medication approach focuses on symptom suppression and patient preferences, including progestins or continuous oral contraceptives while awaiting endometriosis surgery. For adenomyosis or uterine pain, he may offer hormonal medications or a levonorgestrel-releasing IUD to patients who wish to preserve their uterus and are not planning an immediate pregnancy. Muscle relaxants may also complement physical therapy for pelvic floor dysfunction.
For patients experiencing persistent pain after surgery, Dr. Kapetanakis provides ongoing follow-up and a multidisciplinary approach. Care may include pelvic floor physical therapy, gastrointestinal evaluation, dietary support when indicated, and consultation with pain management specialists. He may repeat imaging to investigate potential causes of ongoing symptoms and discuss further laparoscopy to assess adhesions while acknowledging its limitations. His approach emphasizes continued reassessment and personalized support to improve symptoms and quality of life.
City: West Hartford, Connecticut, USA
Philosophy of Endometriosis Care: The teachings of the Mullerian theory as well as the modern genetic/epigenetic theories of inform my approach to endometriosis excision. As such I believe in a radical excision of the disease in the first surgery which will set the stage for effective aftercare via pelvic floor PT modern pain management
What type of surgery do you perform for endometriosis: Excision
Do you include imaging in pre-surgical planning: Typically I will obtain an MRI for most new patients so as to obtain as much information possible on pelvic anatomy (for example the presence of endometriomas, large obvious rectal/rectovaginal nodules, intestinal sub-occlusion etc) acknowledging the limitations of imaging and the fact a negative MRI certainly does not mean endometriosis is absent.
Medication: The role of medications in my practice focuses on temporary symptom suppression as follows: Endometriosis: progestins or continuous use of OCPs in anticipation of excision and according to the patient’s preference Adenomyosis/uterine pain: progestins/OCPs or levonorgestrel IUD as an alternative to hysterectomy when the patient would like to maintain the uterus and is not planning on an immediate pregnancy Pelvic floor dysfunction: muscle relaxants as adjunct to pelvic floor PT
Approach to Persistent Pain After Surgery: I follow all patients until their symptoms improve or resolve with the blueprint of management as follows: – will refer to pelvic floor PT most postoperative patients and check in periodically with them, with a typical follow up 3 months post-op – will refer to GI in order to evaluate for SIBO or other GI -focused residual pathology (this will be an opportunity to work with the dietitian as indicated) – will refer to pain management so as to discuss the feasibility of long-term options such as low-dose naltrexone – will repeat imaging to re-evaluate the anatomy as needed (for example ovarian cyst formation especially on patients who discontinued OCPs or to exclude malpositioning of an IUD) – will discuss second look laparoscopy to evaluate for adhesive disease acknowledging limitations.