Dr. Romeo Lucas, Gynecology & Minimal Invasive Surgery, Endometriosis Specialist.
City: Freeport, Maine
Philosophy:
I employ excision to the fullest extent that I am comfortable operatively. I may call for intra-operative consult as needed. I may ask for certain specialists to be present or available if I have high suspicion before surgery. Even if I am unable to excise or there is not a surgeon available to excise, I thoroughly document the lesions (digital pictures) remaining and review with the patient post-operatively. I then provide referral as needed/desired.
Theories of endometriosis origin:
Most likely due to coelomic metaplasia. Certainly, there are cases owing to menstrual regurgitation (i.e. imperforate hymen) or seeding during surgery (i.e. abdominal wall endometriosis after cesarean delivery). However, in such cases it seems possible if not likely that there is an abberrant immunologic process allowing for unaddressed proliferation of that tissue.
Please tell us about your typical diagnosis strategies for a patient who is suspected to have endometriosis (ex: History, P/E, MRI, US, Laparoscopy, etc)
What type of surgery do you perform for endometriosis?:
Excision