How Our Process Works

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If you would like to become a patient at Pacific Endometriosis and Pelvic Surgery, these documents will explain the process, as well as give helpful information for before and after surgery. Register via the Patient Portal Within our website you will see a button that says “Patient Portal”. This is a link to the secure connection to our EMR (Electronic Medical Record), and allows us to have 2 way communication between the practice and our patients.  You will first need … Read More

Initial Visit

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During your initial visit, we will dive deeper into the details of your symptoms, discuss what’s been done in the past, and do a very detailed physical exam in order to have the best idea possible of what’s causing your pain prior to surgery. If you have pain with bowel movements Dr. Mosbrucker may need to do a rectal ultrasound in order to determine if there is endometriosis within the wall of the distal sigmoid colon or rectum. Most of … Read More

Bowel Prep

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We prefer that most patients do a bowel prep the day before surgery.  This is a kinder, gentler prep that uses Miralax and is much less crampy than older preps such as Go-Lightly. There are several reasons for the bowel prep- first, it allows the colon to collapse and provides better visualization of the pelvis. Secondly, patients tend to have much less constipation and gas pain after surgery, and finally, if endo is found on the colon or if there … Read More

Day of Surgery/Hospital Stay

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On the day of surgery, you will need to arrive at the hospital 2 hours before the anticipated time of your surgery. It is important to remember that the time of surgery is NOT an exact time unless you are the first case of the day, but it is an estimation based on how things are supposed to go in the patients before you. So, please keep your cellphones close to you that day in case we need to call … Read More

The Immediate Postop Period

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Most patients who undergo excision of endometriosis without a hysterectomy or bowel resection should be able to leave the hospital the day of surgery, however everyone wakes up from anesthesia differently. We try very hard to minimize pain and nausea in the immediate postop period so that you can go home (or to your hotel room), however if we are not able to control these adequately you may need to stay overnight. If you need a hysterectomy or a discoid … Read More

Postop Care – The next 6-12 weeks

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The most important things in the first week after surgery are to keep your stools soft, drink adequate amounts of fluid (at least 64 oz. / day), and eat foods that are easily digested (oatmeal, scrambled eggs, fruit, rice, yogurt, etc) and nothing too greasy or spicy. It is common to be a little nauseated for the first couple days after surgery – this can be from left-over anesthesia effects, pain meds, the surgery itself, or a combination of all … Read More

After the Acute Recovery Phase

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Chronic pain sometimes takes a long time to go away. Most of our endo patients have had their pain for many years, so it may not go away in a month or 2.  Patients who have robotic excision of endo with or without a presacral neurectomy will usually have pretty significant menstrual cramps the first few months after surgery. In fact, your first period after surgery may be worse than before surgery. Some lucky folks will have immediate pain relief … Read More

What Is Endo?

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Endometriosis, frequently referred to as just “endo”, is a genetic disease that affects women and causes pain, inflammation, and infertility. The severity of pain varies from person to person, just as the severity of disease does, however they are not linked. What this means is that one person may have mild disease and severe pain, whereas someone else could have severe disease and minimal symptoms. This has led physicians and researchers to call endometriosis “enigmatic”, meaning perplexing or mysterious. In … Read More

Excision of Endometriosis

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What is excision of endometriosis and why is it different? Let’s take a step back and look at the history of surgical approaches to endometriosis. Way back in the dark ages before laparoscopy and lasers, all surgery consisted of cutting a patient open and removing their disease. This approach has been used to treat endometriosis since the 1800s, and a prominent gynecologic surgeon, Dr. Joe Meigs wrote in the 1950s about excision: “…recurrence is not frequent, and cure…by conservative surgery … Read More

My Philosophy on Treating Pelvic Pain Patients

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I view patients who come to me with pelvic pain as a puzzle of sorts. Something is causing pain, and it’s my job to figure out what, and solve the puzzle. After specializing in endometriosis and pelvic pain for over 10 years now, most of the time the puzzle is easily solved, but some patients are very challenging and can take some time to figure out what is truly the root cause of their pain. The quality of pain (sharp, … Read More

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