Selected Podcast
Knowing When It’s Time to See a Gynecology Specialist
Dr. Hattiangadi of EvergreenHealth provides insight into the importance of Women's Specialty Care and Gynecology.
Featuring:
Rohan Hattiangadi, MD, FACOG
Dr. Hattiangadi is a board-certified OB/GYN who has completed specialized fellowship training in minimally invasive gynecologic surgery, including hysteroscopy, laparoscopy, robot-assisted surgery with the DaVinci robot and vaginal surgery. His practice is focused on caring for patients with a multitude of gynecologic conditions, including abnormal uterine bleeding, adenomyosis, endometriosis, uterine fibroids, chronic pelvic pain and uterine prolapse. Outside of EvergreenHealth, he enjoys traveling, gardening, exercising and cooking with his wife and their daughter. Transcription:
Caitlin Whyte: Welcome to Check-up Chat with EvergreenHealth. I'm Katelyn white. And today, we are talking about when is the right time to see a gynecology specialist. Joining us is Dr. Rohan Hattiangadi, a physician at EvergreenHealth Women's Specialty Care Gynecology.
So, this is such a great topic, doctor. To start us off, just tell us about the five most common conditions you treat.
Rohan Hattiangadi, MD, FACOG: So the five most common conditions that I treat include endometriosis and painful periods; abnormal uterine bleeding and that can be either heavy, prolonged, or irregular periods; uterine fibroids, ovarian cysts and chronic pelvic pain.
Caitlin Whyte: And what are the services that EvergreenHealth Women's Specialty Care Gynecology provide to our patients?
Rohan Hattiangadi, MD, FACOG: The first thing that I do for my patients is listen. And what I mean by that is many of these patients, especially those with chronic pain conditions, they've been bounced around from doctor to doctor, but no one really has taken the time to really listen to them or take their complaints seriously. So the first thing I do is listen, I try to get to the bottom of what is causing their ailments and then try to offer the most minimally invasive treatment possible. Sometimes that means medical therapy, sometimes that's surgery. And a lot of times, it's a combination of both.
Specifically, my focus is on what is called as minimally invasive GYN surgery. And that's my specialty. And it isn't about any one specific procedure, rather it's sort of a philosophy about how we can provide surgical care to patients in a way that reduces their morbidity. So we use these endoscopic instruments that are tiny little instruments that we can place through these tiny little half centimeter incisions. And what that does is it gives me the freedom to perform the same complex type of surgeries that I could through an open large laparotomy incision without putting the patients through more bleeding, more pain and a longer recovery. And so what this does is it keeps them out of the hospital and back at home with their families and it helps them to get back at work with a much faster recovery.
Some of the procedures that I perform here include hysterectomy, which is removal of the uterus; myomectomy, which is removal of uterine fibroids, specifically while preserving the uterus. I do cystectomies, which is a removal of cysts from the ovary; prolapse repair, which basically involves helping to elevate a uterus that is prolapsing through the vagina. And then of course, the main bread and butter of my practice is something called excision of endometriosis, where we use laparoscopy to look inside someone's belly and find endometriosis and try to excise or remove as much of it as possible. And I perform all of this through either a laparoscopic approach or with the assistance of a da Vinci robot.
Caitlin Whyte: That's wonderful. So how does this specialty care differ from EvergreenHealth's other women's care practices such as OB-GYN?
Rohan Hattiangadi, MD, FACOG: Yeah, that's a good question. So the EvergreenHealth Women's Specialty Care, you know, is a sub-section gynecology, right? So this practice is designed essentially as a high volume surgical practice. And so we focus entirely on patients with complex pelvic conditions that will most likely require some sort of surgical intervention. And while I love delivering babies, I'm not going to be practicing any obstetrics here. I'll leave that to my wonderful colleagues in the other women's care practice.
So the question is what sets this practice apart from other women's care practices? Well, if we look at most general practices, most gynecologists devote about maybe 10 to 15% of their practice to GYN surgery. And so that leads to about maybe one to two days in the operating room per month and that's maybe a total of 15 to 20 major gynecologic procedures per year, and that's really it. And we know from studying rates of surgical complications and surgeon volume, that if a surgeon produces low volume surgery, isn't in the operating room a lot doing a lot of gynecologic surgery, those surgeries can be associated with increased rates of complications, longer operative times and higher costs.
I mean, to put it simply if you're not doing something often, you're probably not going to be able to consistently do it well. And the more you do something, the better you're going to be at doing it. All of us went into medicine to provide the best care to our patients, right? And so we recognize the importance of high-volume surgeons and high-quality surgical care that we can provide.
So there's this thing called the Fellowship in Minimally Invasive GYN Surgery. And it's a two-year program that you complete after residency. And it's designed to focus on patients with these complex pelvic pathologies that I mentioned before, so advanced endometriosis, uterine fibroids, abnormal uterine bleeding, prolapse, chronic pelvic pain.
And so as a graduate of the FMIGS program myself, over the past two years alone, I performed over 1500 surgeries, including about 350 minimally invasive hysterectomies, either laparoscopic, vaginal or robotic, and about 250 laparoscopic procedures for endometriosis just in those two years. And so in that short amount of time, I spent more time operating than some gynecologists do in maybe 20 years of practice. So, what this means is this advanced surgical training really sets us apart and allows me to provide patients with the safest and best surgical care really possible.
Caitlin Whyte: If a patient can benefit from the services provided that we've talked about today, how are they referred?
Rohan Hattiangadi, MD, FACOG: So right now, you know, obviously this is a new practice. And so we are accepting patients for consultation and Evergreen providers can actually send a referral to this practice through the EvergreenHealth system, through Cerner very easily. Patients and outside providers can actually call our office to schedule a consultation visit or schedule a referral. And that number is (425) 899-4692. We're happy to get you in as quickly as possible so we can talk about what are the main problems that you're dealing with and then is surgery the right thing for you? And if so, how can we tackle that to make sure that it sort of meshes with what your goals are for your own care.
Caitlin Whyte: Wonderful. Well, doctor, is there anything else you'd like to add about the EvergreenHealth Women's Specialty Care you're a part of?
Rohan Hattiangadi, MD, FACOG: I just want to say that I'm very excited. I think this is something that there is a significant need for, especially in this community to have one central place where patients can get their gynecologic care, but also know that they're getting surgery from experienced hands. So I'm very excited to help the women in our community.
Caitlin Whyte: Well, thank you so much for joining us and treating the women in our region with care, doctor. Find out more about the services we discussed today at evergreenhealth.com/gynecology. This has been Check-up Chat with EvergreenHealth. I'm Caitlin Whyte. Stay well.
Caitlin Whyte: Welcome to Check-up Chat with EvergreenHealth. I'm Katelyn white. And today, we are talking about when is the right time to see a gynecology specialist. Joining us is Dr. Rohan Hattiangadi, a physician at EvergreenHealth Women's Specialty Care Gynecology.
So, this is such a great topic, doctor. To start us off, just tell us about the five most common conditions you treat.
Rohan Hattiangadi, MD, FACOG: So the five most common conditions that I treat include endometriosis and painful periods; abnormal uterine bleeding and that can be either heavy, prolonged, or irregular periods; uterine fibroids, ovarian cysts and chronic pelvic pain.
Caitlin Whyte: And what are the services that EvergreenHealth Women's Specialty Care Gynecology provide to our patients?
Rohan Hattiangadi, MD, FACOG: The first thing that I do for my patients is listen. And what I mean by that is many of these patients, especially those with chronic pain conditions, they've been bounced around from doctor to doctor, but no one really has taken the time to really listen to them or take their complaints seriously. So the first thing I do is listen, I try to get to the bottom of what is causing their ailments and then try to offer the most minimally invasive treatment possible. Sometimes that means medical therapy, sometimes that's surgery. And a lot of times, it's a combination of both.
Specifically, my focus is on what is called as minimally invasive GYN surgery. And that's my specialty. And it isn't about any one specific procedure, rather it's sort of a philosophy about how we can provide surgical care to patients in a way that reduces their morbidity. So we use these endoscopic instruments that are tiny little instruments that we can place through these tiny little half centimeter incisions. And what that does is it gives me the freedom to perform the same complex type of surgeries that I could through an open large laparotomy incision without putting the patients through more bleeding, more pain and a longer recovery. And so what this does is it keeps them out of the hospital and back at home with their families and it helps them to get back at work with a much faster recovery.
Some of the procedures that I perform here include hysterectomy, which is removal of the uterus; myomectomy, which is removal of uterine fibroids, specifically while preserving the uterus. I do cystectomies, which is a removal of cysts from the ovary; prolapse repair, which basically involves helping to elevate a uterus that is prolapsing through the vagina. And then of course, the main bread and butter of my practice is something called excision of endometriosis, where we use laparoscopy to look inside someone's belly and find endometriosis and try to excise or remove as much of it as possible. And I perform all of this through either a laparoscopic approach or with the assistance of a da Vinci robot.
Caitlin Whyte: That's wonderful. So how does this specialty care differ from EvergreenHealth's other women's care practices such as OB-GYN?
Rohan Hattiangadi, MD, FACOG: Yeah, that's a good question. So the EvergreenHealth Women's Specialty Care, you know, is a sub-section gynecology, right? So this practice is designed essentially as a high volume surgical practice. And so we focus entirely on patients with complex pelvic conditions that will most likely require some sort of surgical intervention. And while I love delivering babies, I'm not going to be practicing any obstetrics here. I'll leave that to my wonderful colleagues in the other women's care practice.
So the question is what sets this practice apart from other women's care practices? Well, if we look at most general practices, most gynecologists devote about maybe 10 to 15% of their practice to GYN surgery. And so that leads to about maybe one to two days in the operating room per month and that's maybe a total of 15 to 20 major gynecologic procedures per year, and that's really it. And we know from studying rates of surgical complications and surgeon volume, that if a surgeon produces low volume surgery, isn't in the operating room a lot doing a lot of gynecologic surgery, those surgeries can be associated with increased rates of complications, longer operative times and higher costs.
I mean, to put it simply if you're not doing something often, you're probably not going to be able to consistently do it well. And the more you do something, the better you're going to be at doing it. All of us went into medicine to provide the best care to our patients, right? And so we recognize the importance of high-volume surgeons and high-quality surgical care that we can provide.
So there's this thing called the Fellowship in Minimally Invasive GYN Surgery. And it's a two-year program that you complete after residency. And it's designed to focus on patients with these complex pelvic pathologies that I mentioned before, so advanced endometriosis, uterine fibroids, abnormal uterine bleeding, prolapse, chronic pelvic pain.
And so as a graduate of the FMIGS program myself, over the past two years alone, I performed over 1500 surgeries, including about 350 minimally invasive hysterectomies, either laparoscopic, vaginal or robotic, and about 250 laparoscopic procedures for endometriosis just in those two years. And so in that short amount of time, I spent more time operating than some gynecologists do in maybe 20 years of practice. So, what this means is this advanced surgical training really sets us apart and allows me to provide patients with the safest and best surgical care really possible.
Caitlin Whyte: If a patient can benefit from the services provided that we've talked about today, how are they referred?
Rohan Hattiangadi, MD, FACOG: So right now, you know, obviously this is a new practice. And so we are accepting patients for consultation and Evergreen providers can actually send a referral to this practice through the EvergreenHealth system, through Cerner very easily. Patients and outside providers can actually call our office to schedule a consultation visit or schedule a referral. And that number is (425) 899-4692. We're happy to get you in as quickly as possible so we can talk about what are the main problems that you're dealing with and then is surgery the right thing for you? And if so, how can we tackle that to make sure that it sort of meshes with what your goals are for your own care.
Caitlin Whyte: Wonderful. Well, doctor, is there anything else you'd like to add about the EvergreenHealth Women's Specialty Care you're a part of?
Rohan Hattiangadi, MD, FACOG: I just want to say that I'm very excited. I think this is something that there is a significant need for, especially in this community to have one central place where patients can get their gynecologic care, but also know that they're getting surgery from experienced hands. So I'm very excited to help the women in our community.
Caitlin Whyte: Well, thank you so much for joining us and treating the women in our region with care, doctor. Find out more about the services we discussed today at evergreenhealth.com/gynecology. This has been Check-up Chat with EvergreenHealth. I'm Caitlin Whyte. Stay well.