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Recent Articles
April 28, 2011. Health News Digest. Chicago, Illinois.
Women's Health: Restoring Fertility after Tubal Ligation
(HealthNewsDigest.com) - Infertility affects approximately 15
percent of couples, and about 1.3 million women. Some women
intentionally want to be infertile—they are done having children and
don’t want the hassle and side-effects of conventional
contraceptives, so they elect to undergo tubal ligation
sterilization, a surgical procedure that is 99.5 percent effective
as birth control.
An estimated 700,000 to one million women get their “tubes tied”
each year in the United States. It’s the most common contraceptive
method worldwide among married women (33 percent).
Even though tubal ligation is considered a permanent form of
contraception, approximately 10 percent of women have a change of
heart and want to become pregnant again.
“Many women think there’s no hope of conceiving following a tubal
ligation procedure, but they actually have options” said Carlos
Rotman, M.D., F.A.C.O.G, F.A.C.S, chief of gynecology and medical
director of Women’s Health at Weiss Memorial Hospital, and associate
professor of obstetrics and gynecology at Rush Medical College.
Dr. Rotman suggests patients who want to get pregnant, explore these
treatments:
* Tubal reversal. For patients who have undergone tubal ligation
sterilization but are otherwise healthy, this may be the best
option. Known as tubal reanastomosis (or “untying the tubes”), tubal
reversal is the microsurgical repair and reconnection of the
fallopian tubes to restore normal reproductive anatomy. This is
traditionally done through laparotomy (opening the abdominal
cavity), but a select group of surgeons are able to perform it
laparoscopically, using minimally invasive techniques. The success
rates with laparoscopic or open surgery are comparable; however,
laparoscopic tubal reversal results in faster recovery, better
healing, less pain, fewer complications and no large scars compared
to traditional open surgery.
* In vitro fertilization (IVF). This alternative to tubal reversal
avoids risks associated with surgery, but women must endure the
medications needed to stimulate the development of multiple eggs
(which are not without possible complications), the many trips by
the patient and her husband to the doctor’s office, and the high
costs often not covered by the patient’s insurance. For these and
other reasons, IVF is recommended for patients who may not benefit
from tubal reversal because of other fertility problems.
According to Dr. Rotman, “Today, women seeking to become pregnant
after a tubal ligation definitely have choices, but they should do
some research and consult with specialists who offer both medical
and surgical alternatives to ensure they get the type of treatment
that’s best for them.”
For more information on medical options following a tubal ligation
sterilization or Women’s Health at Weiss Memorial Hospital, visit
www.weisshospital.com or call (773) 564-6025.
March 3, 2011. Health News Digest. Chicago, Illinois.
Women's Health: Pelvic Pain & Endometriosis – Treatments for a Problem Many Women Experience
(HealthNewsDigest.com) - Endometriosis is the most common cause of
severe, chronic pelvic pain and infertility. The condition, which
occurs when cells from the tissue that normally lines the inside of
the uterus begin to grow on other organs, affects up to a third of
all child-bearing age women and at different life stages. Fifty
percent of teenage girls with chronic pain will be diagnosed with
endometriosis, and it’s the cause in half of all women who have been
deemed infertile.
“Many women needlessly suffer with this pain,” said Carlos Rotman,
M.D., chief of gynecology and medical director of Women’s Health at
Weiss Memorial Hospital and associate professor of obstetrics and
gynecology at Rush Medical College. “There are a number of
treatments that can alleviate the pain and increase a woman’s chance
to get pregnant. Being diagnosed with endometriosis doesn’t mean a
painful, childless life.”
It’s not clear why some women develop endometriosis, but there is a
genetic component. Proper diagnosis is imperative to getting the
treatment women need, Dr. Rotman said.. In many cases, a primary
care provider may suspect someone is suffering from endometriosis
and will help a patient manage her condition. But in more complex
cases (especially those resulting in infertility or those who have
not responded adequately to the first line of treatment), a referral
to a gynecologist who specializes in endometriosis may be needed.
The best methods for detecting endometriosis are ultrasound, which
uses sound waves to produce an image of the pelvic and abdominal
organs, and laparoscopy, a surgical procedure where a lighted
telescope, attached to a camera, is inserted into the abdomen to
directly visualize the pelvic organs. Endometriosis can have a
distinct appearance, with lesions that look like cigarette burns on
the surface of the pelvic organs and abdominal wall. Keep in mind,
the severity of the pain does not necessarily indicate the extent of
endometriosis.
Once a diagnosis is made, Dr. Rotman says women have several
treatment methods to ease the pain:
* Oral medications. Endometrial tissue relies on estrogen to grow,
so oral treatments such as birth control pills are helpful in
preventing cells from thickening and causing pain, but endometriosis
often recurs when the woman stops taking the medication.
Anti-inflammatory medications also can ease the pain symptoms.
* Hormone-free diet. Going organic, especially with dairy products,
might help this estrogen-feeding disease. Avoid any soy or
phytoestrogens products too.
* Surgery. Sometimes surgery is necessary to remove or destroy the
endometrial tissue if a woman wants to preserve her fertility. After
menopause, when a woman's hormones have declined substantially, this
disease is less of an issue, but for some women beyond their
child-bearing years, a hysterectomy with bilateral
salpingo-oophorectomy (the removal of the uterus, both ovaries and
the fallopian tubes) may be the only solution to eliminating the
pain associated with endometriosis.
March is Endometriosis Awareness Month. For more information on
pelvic pain and endometriosis, visit www.WeissHospital.com.
March 1, 2011. Weiss in the News. Chicago, Illinois.
Weiss physicians, Carlos Rotman, M.D. and Danielle Bass, M.D., have been named “Top Doctors” by Chicago Hospital News and Healthcare Report
Chief of gynecology and Women’s Health medical director, Carlos
Rotman, M.D., and Chicago Center for Orthopedics at Weiss physician,
Danielle Bass, M.D., have been named “Top Doctors” by Chicago
Hospital News and Healthcare Report.
Dr. Rotman leads a new program at the hospital that specializes in
laparoscopic surgery, gynecological oncology, urological gynecology
and robotic surgery of the pelvis and abdomen. Dr. Bass is part of
the Chicago Center for Orthopedics (CCO) team at Weiss, helping to
lead the CCO’s recently opened Urgent Care on Sunday mornings, 9 am
– 1 pm, a time few other doctors are available.
Download “Top
Physicians,” as seen in Chicago Hospital News and Healthcare
Report, for more information.
Click here to view PDF file of the full article.
December 29, 2010. El Imparcial Spanish newspaper. Chicago, Illinois.
Hospital Weiss nombra a Dr. Rotman nuevo Director de unidad de salud de mujeres
Click here to view PDF file of the full article.
July-September, 2009. Journal of the Society of Laparoendoscopic Surgeons. Miami, Florida.
Incidental Appendectomy During Endoscopic Surgery
Song, J.Y., Yordan, E.L., Rotman, C.A.: Incidental
Appendectomy During Endoscopic Surgery.
Journal of the Society of Laparoendoscopic Surgeons, Vol. 13,
Issue 3, Pages 376-383, July-September 2009
Click here to view PDF file of
the full article.
Abstract:
Background and Objectives: The first laparoscopic
appendectomy was performed over 25 years ago, and yet controversy
still exists over the open method vs. the laparoscopic approach, and
whether an incidental appendectomy is warranted. This study aimed to
evaluate our experience in performing a laparoscopic incidental
appendectomy and to address these issues.
Methods: A total of 772 laparoscopic appendectomies
were performed and analyzed and statistically evaluated.
Results: Mean age of the patients was 30.8±7.0
years. Mean operating time for an incidental appendectomy was
12.3±4.5 minutes. Most common pathology result was adhesions, and
the rarest was endometriosis. Of patients with confirmed
appendicitis, 75.8% did not have an initial preoperative diagnosis
of appendicitis. When warranted, 103 (13.3%) patients underwent a
second-look laparoscopy: 75.5% had no adhesions, 23.5% had mild
adhesions, 2% had moderate adhesions. Backward elimination logistic
regression revealed that endometriosis (P=0.016), endometrioma
(P=0.039), pelvic or abdominal adhesions (P=0.015) were associated
with a reduced likelihood of encountering appendicitis on pathology
examination. The complication rate was 0.13%. Anesthesia cost was
lower for an incidental appendectomy compared with an urgent one.
Conclusion: Laparoscopic incidental appendectomy is
safe and quick to perform. Due to the complex nature of confirming
the diagnosis of pelvic and abdominal pain, this study supports the
routine performance of an incidental appendectomy in the female
patient.
Affiliations: 1: TLC Medical Group, SC, Oak Brook
Institute of Endoscopy, Rush Medical College, St. Charles, Illinois,
USA 2: Oak Brook Institute of Endoscopy, Rush Medical College,
Downers Grove, Illinois USA
August 10, 2009. Daily Herald newspaper. Chicago, Illinois.
Fibroid removal could prevent unnecessary hysterectomies
Click here to view PDF file of Page 1 of article.
Click here to view PDF file of Page 2 of article.
May 17, 2009. La Raza Spanish newspaper. Chicago, Illinois.
Alternativa a histerectomía
Médico hispano de Chicago gana premio por video de cirugía avanzada
Click here to view PDF file of article.
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Press Releases
January 4, 2011
New Year Brings New Birth for Once-Sterile Chicago Mother
Weiss Memorial Hospital surgeon provides hope with
laparoscopic tubal reversal.
CHICAGO – Jan. 4, 2011 – Jeanette Custodio thought she
would never be able to have another child, but she’ll be spending
2011 as a new mom once again. Custodio delivered a healthy girl on
Jan. 1, her first child with her husband, Ruben. Custodio underwent
tubal ligation sterilization eight years ago; but last December, the
then 30-year-old Chicago woman underwent a laparoscopic tubal
reversal that gave her hope in getting pregnant again.
The surgery, which repairs and reconnects the fallopian tubes to
restore fertility, was performed by Carlos Rotman, M.D., chief of
gynecology and medical director of Women’s Health at Weiss Memorial
Hospital and associate professor of obstetrics and gynecology at
Rush Medical College. Dr. Rotman, who specializes in advanced
minimally invasive laparoscopic surgery, said Custodio was the ideal
patient for this procedure. “She is early in her child-bearing years
and had no serious health conditions,” he said, adding that there
are many women who are excellent candidates for the surgery.
After Custodio and her then boyfriend had their third child, she got
a tubal ligation, a surgical sterilization procedure that is 99.5
percent effective as birth control. But the nine-year relationship
ended. Custodio eventually married, and she and her husband wanted
to have a child of their own. Her situation is common; a new
relationship with the desire to have children is cited as the number
one reason a woman decides to have a tubal ligation reversal
procedure.
“I couldn’t believe how quickly everything happened,” Custodio said.
“I thought I couldn’t have children again, and then I saw Dr.
Rotman. Within three months, I was pregnant.”
A recognized leader in his field, Dr. Rotman has created and
advanced new techniques and instrumentation in the field of
laparoscopic surgery. He is one of few doctors who routinely perform
tubal reversal laparoscopically, for which he has one of the highest
academically published success rates (pregnancy after reversal) in
the world—a 79 percent pregnancy success rate in women aged 35 and
under who undergo bilateral laparoscopic tubal reversal. The success
rate with the traditional open technique is between 60 and 80
percent.
“Dr. Rotman made me feel comfortable from the start about the
procedure and the chance of getting pregnant again,” Custodio said.
Dr. Rotman typically advises his patients to wait three months after
surgery before trying to get pregnant so the tubes can heal
properly.
“Jeanette’s success with this procedure illustrates the
possibilities for other women who have undergone tubal ligation,”
said Dr. Rotman. “I am delighted to see her have results so quickly
and have such a healthy pregnancy.”
An estimated 700,000 to one million women undergo tubal ligation
sterilization each year in the United States; it’s the most common
contraceptive method worldwide among married women (33 percent).
Tubal ligation closes off a woman's fallopian tubes, muscular organs
connecting the ovaries to the uterus. Surgeons cut, burn or block
the fallopian tubes with rings, bands or clips, which prevents eggs
and sperm from meeting each other for fertilization. Even though
tubal ligation is considered a permanent form of contraception,
approximately 10 percent of women have a change of heart and want to
become pregnant again, and for many of these patients, this can be
achieved through tubal reversal.
In the laparoscopic tubal reversal procedure, instead of a large
abdominal opening, small, specially designed instruments are
inserted through tiny incisions—the largest only one centimeter and
two or three only half that size. The abdominal cavity is visualized
using a laparoscope (a telescope attached to a camera), and the
surgeon removes the blocked area of the fallopian tubes, reattaches
the remaining portions and sutures the tubes together.
The minimally invasive procedure allows the woman to go home the
same day. It also results in faster recovery, better healing, less
pain, fewer complications and no large scars compared to traditional
open surgery.
An alternative to tubal reversal is in vitro fertilization (IVF).
Although women undergoing IVF avoid risks associated with surgery
(e.g., infection or adverse reaction to anesthesia), the biggest
disadvantages of this procedure are the medications needed to
stimulate the development of multiple eggs (which are not without
possible complications), the many trips by the patient and her
husband to the doctor’s office, and the high costs often not covered
by the patient’s insurance.
“This time last year, I was uncertain I could conceive again,”
Custodio said. “Now I sit here in amazement as I hold my beautiful
new daughter, feeling extremely blessed.”
For more information on laparoscopic tubal reversal or Women’s
Health at Weiss Memorial Hospital, visit www.weisshospital.com or
call (773) 564-6025.
MEDIA CONTACT:
For more information:
Karyn Odway
Cushman/Amberg Communications, Inc.
312/263-2500
kodway@cushmanamberg.com
For more information about Weiss:
Catherine Gianaro
773-564-7285
cgianaro@weisshospital.com
###
About Weiss Memorial Hospital
Weiss Memorial Hospital is a Joint
Commission-accredited, 339-bed community health care facility on
Chicago’s North Side overlooking Lake Michigan. Meeting the needs of
its patients through a full range of services, Weiss has more than
400 physicians, many of whom are affiliated with the University of
Chicago Medical Center and University of Illinois Medical Center,
and 43 medical specialties, which offer technologically advanced
diagnostics and effective treatments in a convenient community
setting. For more information about Weiss, go to
www.WeissHospital.com.
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November 15, 2010
Weiss Memorial Hospital Appoints Carlos Rotman MD to Medical Director of Women's Health
CHICAGO (November 15, 2010) — Weiss Memorial Hospital has
appointed Carlos Rotman, M.D., to the position of medical director
of Women’s Health. Dr. Rotman, who is also chief of gynecology at
Weiss, will lead a new program that specializes in laparoscopic
surgery, gynecological oncology, urological gynecology and robotic
surgery of the pelvis and abdomen.
Dr. Rotman is a board-certified gynecologic surgeon who specializes
in advanced operative laparoscopy. As director of the Oak Brook
Institute of Endoscopy, he has created and advanced new techniques
and instrumentation in the field of laparoscopic surgery. He
performs minimally invasive surgeries to treat many gynecologic
conditions, including uterine fibroids, endometriosis and
hysterectomy. He is also one of few doctors who offer laparoscopic
tubal reversal, for which he has one of the highest academically
published success rates (pregnancy after reversal) in the world.
“Dr. Rotman is one of the finest surgeons in his field,” said Frank
Molinaro, chief executive officer at Weiss. “His leadership at Weiss
will provide our patients with innovative treatments, as well as
compassionate medical care.”
The Women’s Health program at Weiss includes experts in complex
gynecological and urological conditions: Edgardo Yordan, MD, a
specialist in gynecologic oncology; Jonathan Song, MD, a specialist
in robotic-assisted gynecological surgery; and Bruce Rosenzweig, a
specialist in urological gynecology.
Last year, Dr. Rotman, Dr. Song, and Dr. Yordan were awarded First
Prize by the American Congress of Obstetricians and Gynecologists
for their video presentation, “Alternatives to Hysterectomy.” This
is the latest in a long series of awards won by Dr. Rotman and his
associates, including the Golden Laparoscope from the American
Association of Gynecologic Laparoscopists.
The Women’s Health office will be located on the sixth floor of
Weiss Memorial Hospital, where patients have convenient access to
primary care physicians, pain management, radiology and imaging, and
oncologists.
“I look forward continuing my work with the medical team at Weiss to
treat patients,” Dr. Rotman said. “These surgeries provide immense
relief for patients, and the laparoscopic techniques provide
shorter, less difficult recoveries.”
Dr. Rotman, a native of Argentina, earned his medical degree from
the University of Buenos Aires and continued training with his
residency and internship at Cook County Hospital. In addition to his
surgical practice, he serves as Associate Professor of Obstetrics
and Gynecology at Rush Medical College.
MEDIA CONTACT:
For more information:
Karyn Odway
Cushman/Amberg Communications, Inc.
312/263-2500
kodway@cushmanamberg.com
For more information about Weiss:
Catherine Gianaro
773-564-7285
cgianaro@weisshospital.com
###
About Weiss Memorial Hospital
Weiss Memorial Hospital is a Joint
Commission-accredited, 339-bed community health care facility on
Chicago’s North Side overlooking Lake Michigan. Meeting the needs of
its patients through a full range of services, Weiss has more than
400 physicians, many of whom are affiliated with the University of
Chicago Medical Center and University of Illinois Medical Center,
and 43 medical specialties, which offer technologically advanced
diagnostics and effective treatments in a convenient community
setting. For more information about Weiss, go to
www.WeissHospital.com.
Click here to return to the top of this page
May 5, 2009
Alternatives to Hysterectomy Video Honored
Prize awarded for advanced surgical technique that could prevent hundreds of thousands of hysterectomies each year.
Chicago, Illinois (PRWEB) May 5, 2009 – A medical video
demonstrating the minimally invasive technique of laparoscopic
multiple myomectomy was awarded First Prize by the American College
of Obstetricians and Gynecologists (ACOG) at their 2009 Film
Festival yesterday. ACOG presented the award to the Chicago-based
surgeons who authored the video, Drs. Jonathan Song, Carlos Rotman,
and Edgardo Yordan.
Of the 600,000 hysterectomies that take place each year in the
United States, more than 200,000 could be avoided according to Dr.
Rotman. “These hysterectomies are performed due to the presence of
benign tumors known as fibroids. While small fibroids are commonly
removed through traditional or laparoscopic surgery, removal of
larger ones is more difficult and requires special expertise. Over
the last 25 years, our team has developed new techniques and
instruments that allow us to remove multiple large fibroids while
preserving the uterus and often preserving fertility as well.”
Known as laparoscopic myomectomy, this minimally invasive surgical
procedure avoids large scars and overnight hospitalization by
utilizing small, specially-designed instruments inserted through
tiny (¼-inch) incisions. The use of sophisticated digital video
equipment allows clear visualization throughout the case.
The authors are members of the Oak Brook Institute of Endoscopy,
which introduced a key innovation known as the “SLAM” Technique.
SLAM stands for Simplified Laparoscopic Abdominal Morcellation, and
involves the use of a straight blade to cut large specimens safely
into long strips, which are then quickly and easily removed.
The prize-winning video demonstrates the team’s technique in the
case of a childless patient who had been told repeatedly at several
institutions that hysterectomy was her only option. Refusing to give
up on having children, she finally contacted Dr. Rotman and his
associates, who found her to be a good candidate for conservative
surgery. They removed several large fibroids – the largest measuring
almost 9 inches – and successfully reconstructed her uterus. The
patient later was able to give birth normally and is presently in
her second pregnancy.
According to Dr. Song, “too many hysterectomies are being performed
in the United States for benign diseases; the uterus does not need
to be easily sacrificed for fibroids.”
Dr. Rotman concluded, “The purpose of this video presentation was to
share our team’s techniques and philosophy with all other
physicians, with the hope that these procedures become more
widespread and patients everywhere will be given alternatives to
hysterectomy.”
Patients interested in contacting the authors can call (800)
244-0212 for Drs. Rotman and Yordan, and (630) 513-9160 for Dr.
Song. Drs. Rotman and Yordan are Associate Professors of Obstetrics
& Gynecology at Rush Medical College, and Dr. Song is an Assistant
Professor of Ob/Gyne there. All three are on staff at Chicago’s
Advocate Illinois Masonic Medical Center; in addition, Dr. Song is
on staff at Delnor Community Hospital in Geneva, Illinois.
ABOUT THE AUTHORS:
Jonathan Y. Song, MD, FACOG, FACS
A member of the medical staff at Delnor Community Hospital, Dr.
Song’s practice is limited to Gynecology and Surgery. He is board
certified in Obstetrics & Gynecology by the American Board of
Obstetrics & Gynecology (ABOG) and certified in Advanced Operative
Laparoscopy by the Accreditation Council for Gynecologic Endoscopy
(ACGE). Dr. Song is an Assistant Professor at Rush Medical College,
Rush University Medical Center, Department of Obstetrics and
Gynecology, and is also a faculty member for WebSurg and SurgeryU,
on-line sites for Minimally Invasive Surgical Education for
physicians. After graduating from Rush’s residency program, Dr. Song
was awarded a fellowship position in Advanced Laparoscopic Surgery
at the Oak Brook Institute of Endoscopy under the direction of Dr.
Carlos Rotman. Upon completion of his fellowship, Dr. Song entered
private practice and works for TLC Medical Group, along with Drs.
Gina Song and Joy Castrovillari in St. Charles, IL. Dr. Song
continues his association with the Oak Brook Institute of Endoscopy,
and in his spare time continues to contribute to surgical textbook
chapters, medical journals, and clinical meeting presentations.
Carlos A. Rotman, MD, FACOG, FACS
Founder and Director of the Oak Brook Institute of Endoscopy, Dr.
Rotman is board certified in Obstetrics & Gynecology by ABOG and
certified in Advanced Operative Laparoscopy by ACGE. An Associate
Professor of Obstetrics & Gynecology at Rush Medical College, Dr.
Rotman’s interest in laparoscopy dates back to his gynecology
residency days in the 1970s. In 1980, together with Dr. Harrith
Hasson, he started to use laparoscopy as a safe and effective way to
perform pelvic and abdominal surgery. The first project was to
improve access to the peritoneal cavity with a minimum of possible
complications, and the result was the Modified Technique of Open
Laparoscopy, now in use all over the world. Recognized in 1994 with
the Golden Laparoscope Award by the American Association of
Gynecologic Laparoscopists for the technique of Laparoscopic Pelvic
Lymphadenectomy, as well as with many other national and
international awards, Dr. Rotman and his colleagues have enjoyed
great recognition and respect for their pioneering and ongoing work,
teaching, and research geared to improving the quality of life of
patients worldwide.
Edgardo Yordan, MD, FACOG, FACS
Board-certified in both Obstetrics & Gynecology and Gynecologic
Oncology by ABOG, Dr. Yordan serves as Chairman of the Division of
Gynecologic Oncology at Stroger (Cook County) Hospital, and is an
Associate Professor of Ob/Gyn at Rush Medical College. Dr. Yordan
was nationally ranked twice by Good Housekeeping Magazine as one of
the “Best 400 Cancer Doctors in the USA” and as one of the “Best
Doctors for Women,” and was named one of “Chicago’s Top Doctors” by
Chicago Magazine. During his long association with Dr. Rotman and
the Oak Brook Institute of Endoscopy, for which he serves as
Co-Director, Dr. Yordan has won the Golden Laparoscope Award and
numerous national and international prizes.
MEDIA CONTACT:
Alfonso del Granado
Oak Brook Institute of Endoscopy SC
773-771-9177
info@oakbrookendoscopy.com
http://www.OakBrookEndoscopy.com
###
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AltAlternatives to Hysterectomy, Part 1 of 2
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Alternatives to Hysterectomy, Part 2 of 2
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