Dr. Patrick Bellelis
Patrick Bellelis, M.D.
Dr Patrick Bellelis – Endometriosis Specialist, Minimally Invasive Gynecologic Surgeon
Summary: Dr Patrick Bellelis is a skilled endometriosis specialist and minimally invasive gynecologic surgeon based in São Paulo, Brazil. With a deep understanding of genetics and epigenetics, Dr Patrick Bellelis focuses on personalized care that addresses the root causes of endometriosis. He emphasizes minimally invasive surgical techniques to provide effective treatment while promoting quicker recovery. For symptom management, Dr Bellelis often uses oral contraceptive pills to help control pain and other symptoms. When patients experience persistent pain after treatment, Dr Patrick Bellelis takes a comprehensive approach, evaluating other potential causes and recommending pelvic physiotherapy and dietary adjustments to support long-term wellness. His patient-centered philosophy ensures that each woman receives individualized care tailored to her unique needs, helping her achieve lasting relief and improved quality of life. Dr Patrick Bellelis combines expertise with compassionate care to guide patients through every step of their endometriosis journey.
City: São Paulo, Brazil.
Philosophy: Genetics and epigenetics
Medication: Oral contraceptive pills for symptom control
Approach to Persistent Pain: Evaluate other causes of pain and associate them with pelvic physiotherapy and adequate diet
Dr. Nicholas Fogelson
Nicholas Fogelson, M.D., FACOG,
Dr Nicholas Fogelson – Endometriosis Specialist, Advanced Pelvic Surgeon, Minimally Invasive Gynecologic Surgeon.
Summary: Dr Fogelson is a leading endometriosis specialist and advanced pelvic surgeon based in Portland, Oregon. Patients from across the country trust Dr Nicholas Fogelson and his clinic, Northwest Endometriosis, also known as NW Endometriosis, for expert, compassionate care. With a strong foundation in the latest research, Dr Fogelson approaches each case with precision and empathy, offering tailored treatments that prioritize long-term relief. Thanks to his reputation for surgical excellence and individualized care, NW Endometriosis has become a top destination for patients seeking advanced support for this complex condition.
At Northwest Endometriosis, Dr Nicholas Fogelson provides excision surgery backed by a deep understanding of the varied presentations of endometriosis. His treatment plans often include pelvic floor therapy, lifestyle guidance, and selective use of hormonal therapy. Whether patients are local or traveling for care, Dr Fogelson and the NW Endometriosis team are committed to delivering ongoing support and expertise every step of the way.
City: Portland, Oregon.
Philosophy: I strongly believe that endometriosis is not one disease, but rather are a constellation of states of similar but not identical disease states. This concept is strongly supported by the very large number of genes that are tightly bound to the disease state, which is more characteristic of a multifactorial and multiorigin disease than a single disease entity. Ie. calling endometriosis one thing is like calling cancer one thing.
Right now the predominant theory is that of mullerianosis, suggesting that endometriosis is a defect of embryogenesis. This theory is supported by a variety of data. At the same time, we also have evidence of environmental factors that seem to promote endometriosis, either through actual genesis of disease or through worsening of the already existent disease and therefore making diagnosis more likely.
The variable response to various therapies among different patients is also suggestive that there is more than one underlying disease state. Ie some patients respond completely to surgical excision and have very little benefit from medical therapies, while some other patients have near-complete cessation of symptoms while on progesterone suppression. Some patients have severe pain, others have no pain, and may only present with infertility. Furthermore, the variability of the appearance of endo surgically also suggests more than one underlying origin. For example, there is a clearly a subtype of endometriosis that presents with high grade rectovaginal deep infiltrating endometriosis, while sparing the ovaries and other peritoneal surfaces. Other patients may have endometriotic implants studded throughout their pelvis, many superficial with perhaps some small deeper areas, without advanced deep disease in any particular area. Again, this suggests a different origin of disease rather than a clinical variation of an identical disease state.
At this point, our understanding of the disease is incomplete. My approach is to individualize care to each particular patient in efforts to improve her quality of life to the maximum. Most patients seek me out for excision surgery, which I do a great deal of. And at this point, excision surgery is the optimal treatment we have available. At the same time, it is critical that we keep an eye out to a better future understanding of the underlying disease that may open up other effective treatment modalities.
Medication: Most of my patients have already been on medical therapies with other physicians and have not found relief, leading them to seek out endometriosis surgery. My primary treatment modality is excisional therapy, but we may augment that with hormonal suppression postoperatively in some cases. Usually, this is only for 3-6 months postoperatively, but in some cases, patients may choose to be on suppression for longer. While in theory, a patient who has had full excision of disease should not benefit from medical therapy, there are some data that do suggest a decreased frequency of recurrent pain in patients who do use progesterone suppression after surgery. These data may be biased by the inclusion of surgery that is not as complete as what is typical in my practice and other expert-level surgeons’ practices, and this may explain this result.
I typically do not use GnRH modulators such as Lupron or Orilissa, as their side effect profile is often worse than the benefit gained, and a minority of women may experience long term harm from their use.
Approach to Persistent Pain: Every case is different, so there can be no one specific approach. Most patients have thorough excision of endometriosis as part of their treatment. Most experience substantial relief from this, but over time some may have recurrent pain.
All patients should be evaluated by a skilled pelvic PT and get support for pelvic floor pains. When this is severe pelvic floor botox may be appropriate. We also have to consider urinary tract sources of pain such as interstitial cystitis. When appropriate, some patients may have repeat laparoscopy if we believe there may be recurrent or residual disease (particularly if a patient comes in after surgery from an outside surgeon. We also must evaluate other neurologic sources of pain, such as vascular or ligamentous entrapment of pelvic nerves (ie nerve roots, sciatic, femoral, obturator, pudendal, etc.). In limited cases, direct neurolysis of affected nerves may lead to relief. When a persistent pain can be neurologically localized but is not addressable surgically, or surgery has failed to relieve the pain, direct neurostimulation of affected nerves can have substantial efficacy in decreasing or even eliminating pain. We also encourage all patients to eat a healthy anti-inflammatory diet and to get regular exercise.
While some patients travel to see us, many patients come from our local area and continue to work with our practice ongoing for their routine care as well as any issues of recurrent pain. We are committed to continuing to care for all of our patients, as long as it is practical for them. While many patients do travel for surgery, we think that the best care comes with an ongoing relationship with a physician who not only can operate but has a wide base of knowledge in pelvic pain, and can help manage care actively.
Dr. Ramiro Cabrera Carranco
Ramiro Cabrera Carranco, M.D.,
Doctor Cabrera – Endometriosis Specialist, Gynecologist, and Laparoscopic Surgeon.
Summary: Doctor Cabrera, is a compassionate endometriosis specialist and gynecologic surgeon based in Tijuana, Baja California. Patients seeking expert care in dr Cabrera Mexico turn to him for his advanced training in laparoscopic excision surgery and deep commitment to personalized treatment. Dr Cabrera OBGYN approaches endometriosis through the lens of the mesodermal origin theory—understanding it as a condition rooted in fetal development. This unique perspective informs the holistic, long-term care that defines Ramiro Cabrera endometriosis treatment, making him a trusted choice for those seeking real answers.
Doctor Cabrera combines surgical excellence with supportive therapies, including pelvic floor physiotherapy, an anti-inflammatory lifestyle, and supplements. Dr Cabrera OBGYN only recommends hormonal treatment when necessary, prioritizing conservative yet effective care. Patients experiencing persistent or complex pain are thoughtfully evaluated, often with referrals to neuropelviology. With a growing reputation across borders, Cabrera Mexico remains a leading destination for Ramiro Cabrera endometriosis expertise and whole-person healing.
City: Tijuana, Baja California, Mexico
Philosophy: Our approach to the treatment of endometriosis is based on the mesodermal origin theory, which suggests that individuals are born with endometriotic-like cells due to embryological misdifferentiation of the mesoderm. This theory posits that endometriosis is not solely a retrograde menstruation phenomenon but rather a condition that originates during fetal development, where misplaced Müllerian or mesothelial cells retain their potential to differentiate into endometrial-like tissue later in life.
What type of surgery do you perform for endometriosis: Excision
Medication: Hormonal treatment, primarily progestins, only when necessary; anti-inflammatory diet; pelvic floor physiotherapy; anti-
Approach to Persistent Pain: If the symptoms indicate neurological alterations, evaluation by neuropelviology or pain management treatment is recommended.
Dr. Antonio Rosario Gargiulo
Dr Antonio Gargiulo MD
Dr Antonio Gargiulo – Endometriosis Specialist, Gynecologist
Summary: Dr Antonio Gargiulo is a leading endometriosis specialist Boston patients trust for expert, compassionate care. As a highly respected gynecologic surgeon based in Boston, MA, Dr Antonio Gargiulo is known for his advanced techniques and individualized approach to treatment. Patients from across the U.S. seek Antonio Gargiulo MD endometriosis care for its innovation, depth, and dedication to whole-person health. Whether you’re searching for a highly experienced endometriosis specialist in Boston or have been referred to Doctor Gargiulo by another provider, his reputation for excellence and holistic, evidence-based care sets him apart.
While the exact causes of endometriosis are still under investigation, Dr Antonio Gargiulo supports the theory of a polypotential germ-cell origin. In clinical settings, Doctor Gargiulo often begins treatment with FDA-approved progestins and NSAIDs, reserving GnRHa primarily for patients with adenomyosis preparing for IVF. His thoughtful, personalized strategies help patients manage symptoms while minimizing unnecessary interventions.
When facing chronic or complex pelvic pain, Antonio Gargiulo MD endometriosis care expands well beyond standard gynecological evaluations. Doctor Gargiulo integrates comprehensive assessments across specialties, including urology, gastrointestinal, neuro-orthopedic, rheumatology, and mental health domains. His approach ensures coexisting or overlooked conditions are addressed, and that issues such as adhesions or hernias are not missed. Physical therapy and regular follow-ups are also central to his long-term treatment plans.
With unmatched expertise and a commitment to multidisciplinary, compassionate care, Dr Antonio Gargiulo remains a leading name in the field. As a trusted endometriosis specialist Boston patients rely on, Doctor Gargiulo continues to provide clarity, relief, and lasting solutions in the often misunderstood world of endometriosis.
City: Boston, MA, USA
Philosophy: Etiology is yet unclear. Polypotential germ-cell origin is a promising hypothesis.
Medication: My first line is FDA-approved progestins and NSAIDs. I use GnRHa exclusively for adenomyosis patients in the setting of IVF.
Approach to Persistent Pain: Expanding diagnostic approach (uro, GI, neuro/ortho, rheumatology, psyche). Expanding physical therapy approach. Clinical reevaluation for possible residual disease or iatrogenic disease (hernia, adhesions). Pain service.
Dr. Ken Sinervo
Dr Ken Sinervo, M.D., M.Sc, F.R.C.S.C., A.C.G.E.
Medical Director, Center for Endometriosis Care
Gynecology & Minimal Invasive Surgery
Endometriosis Specialist.
Summary: Dr Ken Sinervo, M.D., M.Sc., F.R.C.S.C., A.C.G.E., is a globally recognized leader in the treatment of endometriosis and the Medical Director of the Center for Endometriosis Care in Atlanta GA. With decades of experience, Dr. Ken Sinervo is renowned for his expertise in minimally invasive excision surgery and his compassionate, patient-focused approach. Patients from around the world travel to see Dr Ken Sinervo Atlanta GA for advanced care that addresses the full complexity of this challenging condition. As a leading expert in the field, Ken Sinervo gynecology services are known for combining surgical precision with a deep understanding of chronic pelvic pain and reproductive health. Whether patients are newly diagnosed or have struggled with endometriosis for years, Dr Ken Sinervo offers hope through highly individualized treatment. His reputation for excellence continues to make Dr Ken Sinervo Atlanta GA a trusted destination for those seeking specialized care. With a strong foundation in evidence-based medicine, Ken Sinervo gynecology expertise reflects a commitment to both innovative treatment and long-term patient support.
City: Atlanta, GA, USA.
Dr. Ken Sinervo is a world-renowned expert in the excision of endometriosis and multidisciplinary care of the disease. A humble, compassionate surgeon who truly cares for his patients, he has won countless awards for his dedicated service and is known to always go above and beyond for those in his care.
Philosophy: Endometriosis can likely be ascribed to embryologic origins as upheld by Redwine’s Mülleriosis theory, which suggests that the disease is created following abnormal differentiation of the Müllerian duct system during embryogenesis and later triggered by varied mechanisms.
Medication: When patient has chosen the option based on their specific circumstances and indications; LNR-IUS for adenomyosis, short-term ovulation suppression (3-6 immediately post-operatively) with either continuous low dose contraceptives or progestins such as norethindrone. Narcotics/pain medication as needed/appropriate.
Approach to Persistent Pain: Re-assessment of potential causes of pain. Pelvic floor PT where needed. Pain management where needed – trigger point injections, nerve blocks, medication. If need for narcotics, and have had appropriate referrals to other specialists where necessary, then we would consider another laparoscopy. Happens less than 10-15% of the time.
Dr. Andrea Vidali MD
Dr. Andrea Vidali, M.D
Endometriosis Specialist, Obstetrics & Gynecology / General Obstetrics & Gynecology, Reproductive Endocrinology
Summary: Dr Andrea Vidali MD is a highly regarded endometriosis specialist and reproductive endocrinologist based in New York, NY, USA. Known for his expertise and compassionate approach, Dr Vidali offers comprehensive care for patients dealing with complex endometriosis cases. His practice attracts individuals from both the New York City area and beyond, especially those searching for a trusted expert like Andrea Vidali NYC. What makes Dr Andrea Vidali endometriosis treatment unique is his focus on combining excision surgery with targeted medical therapies, such as progestins and IUDs. This approach not only helps control bleeding but also addresses related conditions that often go untreated. His methods are especially effective for patients who haven’t responded well to hormonal therapy alone.
In addition to his surgical skill, Dr Vidali emphasizes the importance of personalized, long-term care. Every patient receives a tailored recovery plan that may include physical therapy and collaboration with physiatrists to help manage persistent pelvic pain. This ongoing support is a key part of the experience with Dr Andrea Vidali MD, who believes that successful treatment doesn’t end in the operating room.
Many patients turn to Dr Andrea Vidali MD not just for his medical knowledge, but for his commitment to improving their overall quality of life. Whether you’re local to New York or researching providers like Andrea Vidali NYC from across the country, his integrative approach to endometriosis makes him a leading choice in the field. It’s no surprise that Dr Andrea Vidali endometriosis care is so highly sought after by those navigating this challenging condition.
City: New York, NY, USA
Philosophy: Current scientific evidence points to the coelomic theory of endometriosis
Medication: The approach to endometriosis has to be holistic and address not only the disease itself but also potentially associated conditions. At this time, since we do not have medical candidates for curing endometriosis, the first essential step in the treatment of endometriosis is excision surgery. Additionally, Dr. Vidali rely on hormonal contraception, preferably progestins either orally or in the form of IUD to control bleeding or adenomyosis-related factors, if present. He does not rely on GnRH agonists or antagonists as in my experience the risk profile and efficacy profile not better than progestins make them undesirable.
Approach to Persistent Pain: I would like to affirm that I follow all the patients I operate on until they are well. I see the patients periodically as long as necessary. I always have a plan post-operatively especially if history, lab work, and initial examination have highlighted the possibility of the coexistence of additional pain generators. I do recommend physical therapy to most if not all patients and rely on a network of physiatrists.
