Working Life: Endometriosis causes inflammation and scarring in the pelvis

Alison DeMaio, consultant gynaecologist, Supra-Regional Endometriosis Centre, Tallaght University Hospital

Fri, 29 Mar, 2024 - 02:00

Catherine Shanahan

6.15am

No need for alarms. Morning starts with two hungry cats (Rosie and Bruce) ‘gently’ reminding me of breakfast time. I feed them before heading to work.

7.30am

I meet with the team to discuss patients coming in for surgery. We go on a ward round to see them, answer questions, and ensure their hospital admission goes smoothly.

8.15am

In the operating theatre, each team has a pre-operative ‘huddle’ to discuss the day’s list. It includes surgeons, anaesthetists (and their trainees), the theatre manager and nursing colleagues. We discuss the procedures planned, difficulties that may arise, and how best to ensure the list runs smoothly and safely.

Surgery is never a lone endeavour: I work with trainees at various stages of training. Before each procedure, we again review the
patient’s file and images they have had prior to surgery as well as findings at previous multidisciplinary meetings. I assign roles for trainees and use this time as a teaching moment.

9am

Today is a combined list with our consultant colorectal colleague Cillian Clancy. As a supra-regional referral centre for endometriosis care, we often care for women with severe disease undergoing complex surgeries.

Endometriosis is a chronic inflammatory condition where tissue similar to the lining of the womb (the endometrium) is located outside the womb. This causes inflammation and scarring in the pelvis, and sometimes beyond the pelvis, and can cause debilitating pain.

The Tallaght University Hospital team looking after women with endometriosis includes many specialities and our surgeries include keyhole, robotic-assisted, and open surgery. When organs like the bowel or bladder are involved, we work with colleagues in colorectal surgery and urology.

Due to the complexity of today’s cases, only two ladies were booked for surgery. On other days, it could be as high as six or seven.

5.30pm

We finish our list as the last patient goes to the recovery area. We have a second ‘huddle’ to discuss how things went ahead of a ward round by the team to see patients who underwent surgery. We update them on how it went.

6.30pm

Home to my chatty cats, who are keen for cuddles. My husband is a keen cook, and while he is making dinner, I get out my yoga mat and do some gentle movements to offset the long day on my feet.