Testimonials

1/08/2024

I am eternally grateful to this spectacular team, Professor Horace Roman, one of the best endometriosis surgeons in the world, thank you so much for all the teaching and opportunities, and to Dr Thomas Dennis and Dr Benjamin Merlot, excellent surgeons and better people.
It has been the best of months for me to be with you at IFEMendo, a global center for endometriosis management.

14/3/2020

In my quest to learn the best about endometriosis, all my research led me to one person: Horace Roman, who works in France.

My visit to the Tivoli Ducos clinic in Bordeaux, France, was a life-changing experience. I'm sure that patients also feel the same positive vibes that I experienced when taking detailed histories, undergoing meticulous clinical examinations, and confirming results with further investigations such as MRI. They leave no stone unturned until they can finally explain the situation to the patient in plain language, enabling them to choose the most logical and scientifically sound treatment best suited to their particular case.

My passion and quest to learn all about one of the most complex diseases, endometriosis, came to fruition in this incredible center and hospital, where patients are treated with such care and compassion. The doctor encourages and builds the patient's confidence from the moment she enters the hospital.

Dr. Horace Roman and Dr. Benjamin Merlot's self-assurance and optimism towards patients is palpable in their approach, and this is simply remarkable and inspiring. Patients finally feel listened to and understood.

When it comes to surgery, I'm not exaggerating when I say that Dr. Horace Roman is by far the most experienced and outstanding surgeon in the field of endometriosis. He is an excellent decision-maker, and his vast experience is the key to his patients' success in their fight against endometriosis.

Every minute spent here is like collecting pearls of wisdom. I'm not being dramatic when I say I've seen some of the most difficult cases of my career.

You're sure to see bowel resections, shaving techniques, discoid resections, and logically learn to select the best approach for each case. I've also seen cases of ureteric endometriosis and numerous ureteric reimplantations.

I guarantee you won't be able to resist praising this team when you see their approach to extreme cases of neurological damage due to endometriosis.

25/11/2019

Written report from the British Society of Gynaecological Endoscopy (BSGE) to the committee

Dear BSGE Committee,

I would like to thank you for awarding me a BSGE training travel scholarship to further my training in gynecological endoscopic surgery. I had the exceptional opportunity to visit Professor Horace Roman, an expert in endometriosis, at his center in Bordeaux, France, from September to October 2019.

During this travel fellowship, I had the opportunity to immerse myself in advanced laparoscopic techniques dedicated to endometriosis under the guidance of Professor Roman and his specialized multidisciplinary team. I was able to conclude my visit by fulfilling my training objectives, including establishing relationships with many international colleagues.

During my visit, I was very interested in observing and learning about the standard operating room practices applied by the Bordeaux team. I noted some differences from practices in the UK and Australia. Professor Roman's operating room team pays great attention to aseptic measures, which led me to reflect on my own department's practices and assess opportunities for improvement. In comparison, Professor Roman's patients have an overall infection risk of 10%. I believe that the special attention paid to skin preparation helped to reduce the infection rate in this type of high-risk surgery, often involving bowel and vaginal procedures. There were also no significant differences in antibiotic regimens compared with patients in our study. In addition to skin preparation, the team uses a single surgical drape that exposes the abdominal region and covers the entire patient, with an adhesive strip around the margins. This single use can also reduce the risk of contamination from the application of multiple drapes. In addition, the use of a low-pressure pneumoperitoneum with AirSeal can also improve surgical results.

Professor Roman is an exceptional surgeon, but he achieves this excellence thanks to his dedicated team. The operating room team functions flawlessly, and each member is treated with the utmost respect. Their teamwork is exemplary and inspires respect in any operating room in the world. There is a mutual trust that enables everyone to contribute to the well-being of patients. Professor Roman is assisted every day by the same highly skilled and proactive instrument nurse, able to anticipate Professor Roman's every move. If the OR team has any questions about the surgery, Professor Roman takes the time to listen - an extra measure of safety for the patient.

Patients recover very well from general anaesthesia after major surgeries such as advanced endometriosis excision with bowel surgery, which may include resections and stomas. They benefit from excellent pain management and, generally, are mobilized quickly and can even leave the hospital soon afterwards. In addition to best surgical practices, another factor contributing to good pain management and rapid mobilization is the pain management protocol used by the anesthesia team for patients with endometriosis.

This pain protocol ensures optimal baseline relief, then adjusted with medication as needed. Opioids are not the main component of pain management. A numerical pain scale is used to guide patients and nurses in the prompt administration of analgesics to avoid pain exacerbation. This protocol is rigorously followed by all anesthetic staff, ensuring consistency in the prescription and administration of analgesics.

Gynaecologists from all over the world come to observe Professor Roman's work. During my stay, I had the opportunity to network with colleagues from Paris, Israel, Jordan, Turkey and Morocco. It was a real pleasure to exchange knowledge and explore interesting ideas and concepts in gynecology. I established friendships and professional networks that will undoubtedly prove invaluable in the future.

I also had the opportunity to write up some research for Professor Roman. He has published extensively in the field of intestinal endometriosis and uses double-disc resection to treat endometriosis nodules too large for a single resection, or when the integrity of the anastomotic suture requires reinforcement. To date, he has performed 22 such procedures. I had the opportunity to review the data, analyze it and write an article for submission, which enabled me to deepen my knowledge of intestinal endometriosis and compare his results with published data.

Professor Roman is a humble and genuine person, who shows great respect for staff and patients alike. He constantly innovates in his practice, listens to everyone's ideas and opinions, but above all, he shares his knowledge and experience with us. He regularly performs live operations, and if he encounters a complication, he acts with transparency and implements the necessary measures to ensure the best care for the patient. He is an exemplary model of a surgeon, and it was a great honor to attend this fellowship with him. I had the opportunity to learn many advanced dissection techniques and surgical procedures from him and his team.

In conclusion, I gained a comprehensive view of the practices of a center of excellence for endometriosis. I was able to reflect not only on advanced surgical aspects, but more importantly on primary surgical care practices and patient care that I can improve for my own health service. I leave his unit with the hope of returning one day.

Thank you,

Dr Shamitha Kathurusinghe

01/07/2019

Written report from the British Society of Gynaecological Endoscopy to the committee

It was with great excitement that I set off for Bordeaux to spend a month immersed in deep infiltrating endometriosis surgery. I must thank my clinical director, Ingrid from Oxford, for enabling me to pursue this quest for in-depth knowledge.

Professor Horace Roman's hospitality and benevolence knew no bounds. At any given time, he was welcoming numerous colleagues and teams from all over the world, all of whom had come with the same objective: to deepen their knowledge of endometriosis surgery. During my stay, I met experienced surgeons as well as up-and-coming talents in the field of endometriosis surgery from Australia, Denmark, Italy, Jordan, Romania and, of course, the UK.

One of my objectives was to observe Horace's approach to severe cases of endometriosis involving the colon, bladder, vagina, deep splanchnic nerves and diaphragm. I also wanted to understand the types of data he collects that enable him to contribute so effectively to endometriosis research.

Horace uses advanced surgical equipment to excise any deep infiltrating endometriosis. I've seen a significant improvement in depth perception with 3D laparoscopy, particularly when dissecting and excising rectovaginal nodules.

The Plasmajet creates planes that facilitate ureterolysis and rectovaginal shaving, making these procedures almost effortless. Other advantages include the ability to ablate endometriosis from intestinal surfaces with minimal thermal spread and depth penetration. I've also gained a better understanding of the delicate decision-making involved in deciding whether to proceed with disc excision, Rouen excision or segmental resection, as the case may be.

Another important learning point was endometrioma management, to minimize damage to the ovarian reserve. Horace begins by draining and flushing the endometrioma. He then injects 95% alcohol into the endometrioma for 10 to 15 minutes. He explained that alcohol sclerotherapy destroys the epithelial covering of the cyst by coagulation necrosis, a fibrosis covers the internal cavity and prevents endometrioma reformation in 91% of cases after 3 years of follow-up, while maintaining a natural pregnancy rate of 57%. Another technique involves draining the endometrioma, turning the cyst wall inside out and ablating it completely with the Plasmajet. Both methods avoid damage to the ovarian cortex and oocytes.

Bordeaux is a very pretty and exciting city to visit. I was able to attend a music and gastronomy festival. I also spent an evening with a team of Italian surgeons. The whole experience was enriching and inspiring. I returned to Oxford with a renewed desire and enthusiasm to implement positive changes in the management of endometriosis.

Dear Horace,

I spent a few days at your Center of Excellence last year. They were days filled with an incredible surgical experience, with at least 5 colorectal resections a day. An experience I never thought possible.

Participating in the surgeries with you and Benjamin taught me so much. This wealth of knowledge, both surgical and medical, has, in my opinion, opened my eyes to the surgical management of endometriosis.

A future collaboration was also made possible, with Benjamin performing live surgery at our meeting of the Israeli Society of Gynecological Endoscopy last February.

I'm also grateful for the new friendships I've made with you and Benjamin since my last visit.

At my center, we're all waiting for this Covid-19 epidemic to end so we can get back...

When we parted, I thanked you for my visit to the "Temple of Endometriosis". I've been thinking that ever since.

I'm eternally grateful.

02/09/2020

Director of Global Development, International Society of Neuropelveology [ISON] Past President International Society of Gynecological Endoscopists [ISGE] Founder Vice President Asia Pacific Association of Gynecological Endoscopists [APAGE] Past President Indian Association of Gynecological Endoscopists [IAGE] Mangeshikar MAGIC for Women Center For Gynecological Endoscopic Surgery, Mumbai, INDIA

My dear Professor Horace Roman,

It's been almost 5 months since Abhishek and I spent a week at your Center of Excellence, Clinique Tivoli Ducos, for the week-long workshop on understanding endometriosis.

The training you gave us in recognizing and treating advanced endometriosis, through your lectures and the hands-on training we received as observers and participants in your operating theatre, with a large number of cases of advanced endometriosis - 22 to be exact in 5 days - opened our eyes to a simplified, step-by-step approach to understanding the retroperitoneum, the disease: endometriosis, and a systematic method for excising endometriosis. Your surgical skills are exemplary, and your ability to share your knowledge and skills rightly places you on the pedestal of PROFESSOR. It was an honor for me to be your student, observing every step you performed in the operating room, and you guided us to make the most complex surgeries more accessible, focusing primarily on excision of gastrointestinal, urological and pelvic nerve endometriosis.

Professor Roman is a highly skilled and experienced surgeon in the treatment of endometriosis. He is internationally recognized and respected by his peers. I have observed that he is able to excise the disease completely, even in the most complex cases.

I highly recommend that those who wish to excel as expert endometriosis excision surgeons spend time at this Center to learn the valuable teachings of PROFESSOR HORACE ROMAN.

I look forward to visiting the Clinic as Professor Roman's student once again.

Thank you once again.

Best regards,

Prashant

Dear Professor Horace Roman,

It all started when I discovered your videos on LinkedIn and YouTube, and then I had the incredible opportunity to see my dream come true by joining your team and working alongside you, Professor. During 18 months of hands-on training, I gained the greatest experience of my life by participating in over 400 operations on the most complex endometriosis cases ever seen around the world, as well as contributing to research, articles, congresses, meetings and consultations.

I'm very proud to have had the opportunity to join you, your great team and your colleagues Benjamin, Damien and Mylène.

I'll never forget these golden days and every moment of your precious time and invaluable experience.

I wish you all the best for the future.

Most sincerely...

17/08/20

Dear Professor Roman,

I would like to thank you for welcoming me to your center. Having the opportunity to observe live one of the world's experts in endometriosis was a real pleasure. I'd been following you online for some time and was impressed by the type of surgeries you perform. Being able to witness a discoid resection live was invaluable. Watching in your operating room allowed me to see your organization and to better understand how the different stages of surgery unfold.

I knew the surgeries would be excellent, but I didn't expect so much kindness from you and your team. You have a genuine desire to teach and share your knowledge. I hope to return to your center in the near future, and this time for a longer period.

Sincerely,

Dr Jaime Ocampo

18/8/2020

Dear Horace,

It is with great pleasure that I would like to thank you for the opportunity to visit your Endometriosis Competence Center and participate in some of your procedures to gain knowledge on the advanced management of deep infiltrating endometriosis. As an endometriosis surgeon for many years, it was an extraordinary experience for me to gain new perspectives and an inside view of your "Rouen technique", which I consider a major advance in surgery for deep infiltrating endometriosis. This technique undeniably reduces surgery time and perioperative morbidity, while producing convincing clinical results!

As important as the surgical techniques, the discussions and exchanges around preoperative treatment and diagnostic procedures have been invaluable in advancing my own work efforts.

Thank you for your hospitality and friendship - I look forward to seeing you again as we continue our work together on endometriosis!

Best regards,

Ralf Bends, Cologne, Germany

21/11/2018

It was a real pleasure to visit Professor Horace Roman and his team in Bordeaux with my colleagues from the Harley Street Endometriosis Centre in London. We received a warm welcome and were able to witness top-class laparoscopic surgery for severe cases of endometriosis. We discovered and learned about the innovative technique of discoid bowel resection using the CDH stapler for endometriosis, which over the past two years has become the procedure of choice for suitable patients at our center.

We can't thank Professor Roman enough for his professionalism, and look forward to seeing him in the operating theatre again, whether in Bordeaux or London.

I was in Bordeaux as a trainee with Professor Horace Roman between September 2019 and March 2020. My training program was originally scheduled to run until July 2020, but was interrupted due to the Covid-19 pandemic.

Although the program ended earlier than planned, I took part in over 150 surgical procedures, 100 of which were for colorectal endometriosis. This is a considerable number, and I think it would be impossible to gain such experience in just seven months at other centers.

I'm delighted to have been an intern with Professor Horace Roman. The Tivoli Endometriosis Center in Bordeaux opened my eyes to the field of endometriosis. It has changed my approach to endometriosis patients, especially those with colorectal endometriosis.

The multidisciplinary meetings with the radiologist were very interesting and instructive. During my training, I also learned how to read MRI scans of patients with endometriosis.

Professor Horace Roman's center is also a research center. It is possible to take part in research projects. During my training, I wrote two articles on endometriosis.

I would like to thank my dear mentor, Professor Horace Roman. It was the most rewarding training of my professional career.

15/07/2020

I completed a four-week observation placement at Clinique Tivoli-Ducos in June 2019. It was an incredible experience, both professionally and personally. Professor Roman is not only a highly qualified surgeon and prolific researcher, he is also a dedicated teacher, very generous with his time and knowledge. He and his team at the Clinic welcomed me warmly, and I was able to observe and witness the procedures every day. At every possible moment, he explained and commented on his techniques to maximize every teaching opportunity, often in several languages simultaneously.

I had the opportunity to attend operations where techniques such as the Rouen technique, discoid excisions, bowel resections and sacral nerve root dissection were performed, among other procedures. It was a unique opportunity to observe Professor Roman performing complex and radical excisions of colorectal endometriosis, and I was able to learn a great deal in a very short time, with up to six surgeries performed each day.

What's more, Bordeaux is a beautiful city, rich in cultural, historical and gastronomic attractions, and is also the center of the famous Bordeaux wine region. I can only highly recommend a visit.

Dear Horace,

It's already been three months since I returned to Israel after my extraordinary year in France, and the strength and energy you transmitted to me continue to push me full speed ahead! Many people say that 2020 was a very bad year, but for me personally, it led me right to you. Looking back, it was pure luck and the best thing that ever happened to me. Thanks to your teaching and advice, you made me believe it was possible! When I returned to Israel, I had both the professional knowledge and the courage to present my superiors with a detailed plan to open an endometriosis center in my hospital. I'm so happy and proud to tell you that last week we officially opened our new endometriosis center, which includes not only the surgical aspects but also the diagnostic part (ultrasound and MRI), the fertility aspect with fertility preservation, and long-term treatment with a psychologist and a physiotherapist specialized in the pelvic floor.

I left Bordeaux a few months ago, but I'm still learning a lot from you! Following your YouTube channel and your webinars, I almost feel like I'm back in your operating room with you :). So, once again, thank you so much for everything. I'm proud to be your student and look forward to visiting you again, even for a few days, to learn and expand my knowledge as soon as the COVID situation allows.

Good morning, Professor,

I'm Dr. Vivek Salunke from India, and I've just returned home after attending your wonderful five-day program with you and your team. I greatly appreciate your efforts, hospitality and openness in teaching. I gained a great understanding of endometriosis management involving the gut, nerves and diaphragm. A huge THANK YOU, Sir, for all you have taught us. Special thanks to Dr Benjamin and Isabella. We look forward to welcoming you to India in the near future. We follow your videos and will participate in the meetings organized by you. Thank you again.

Dr Vivek Salunke

Regardless of your level of surgical skill and experience, seeing how other surgeons approach similar difficult surgical situations is essential if you wish to continue to improve as a surgeon. I'd like to thank Horace Roman for generously sharing some of his most complex cases this week, including an extremely complicated patient from England with a large endometriosis nodule involving the sacral nerve root and pudendal nerve, with a history of multiple bowel leaks and small bowel obstruction after segmental resection. I feel fortunate to have witnessed one of the most difficult and time-consuming cases of his brilliant career. I sincerely appreciate his honesty and authenticity, both as a person and as a surgeon.