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Témoignages

Témoignages des visiteurs étrangers

De septembre 2018 à mars 2020, notre centre a été visité par 110 chirurgiens gynécologues et digestifs, qui se sont déplacés afin d’apprendre ou perfectionner leurs connaissances dans la prise en charge de l’endométriose. Parmi eux, 56 chirurgiens étaient des collègues étrangers provenant de 5 continents différents. Certains déplacements ont été financés par des bourses d’études (fellowship) et les chirurgiens (fellows) ont rédigé des rapports de stage qui nous ont été adressés en copie.

14/3/2020

Sandesh Kade

Gynecologist Surgeon, Dubaï

In my pursuit to learn the best in endometriosis all my research guided me to a person Horace Roman who works in France. My visit to Tivoli Ducos clinic in Bordeaux, France was nothing short of a life changing experience. I am sure the patients too echo the same positive Vibes which I experienced when I attended their detailed history taking and meticulous clinical examination and reconfirmation with added investigation like MRI and leaving no stone unturned until they finally could explain the situation to the patient in a simple language so that she can make her most logical and scientifically backed up treatment options most suited for her individual case. My passion and quest to learn everything about one of the most complicated disease Endometriosis was achieved in this incredible centre and hospital where the patients are treated with so much care and compassion. The doctor encourages and raises the confidence of the patient the moment she registers with the hospital. Dr. Horace Roman’s and Dr Benjamin Merlot’s reassurance and optimism towards the patient is so visible in their approach, it is commendable and inspiring. The patient is put to such ease and comfort and they feel that their problem is finally heard by someone. Coming to the surgery I will not exaggerate but reiterate and acknowledge the fact that Dr. Horace Roman is by far the Most experienced and amazing surgeon in the field of Endometriosis. An excellent decision maker and his vast experience is the key to his patients success in their battle against endometriosis. Every minute sent here is like gathering pearl’s of wisdom. I am not exaggerating but I attended the most difficult case’s in my life. You are sure to attend bowel resections, shaving, discoid resections and logically learn to select the best for each case. I attended ureteric endometriosis and multiple case’s of ureteric reimplantation. I vouch you will not stop praising this team when you see the way they approach the extreme cases of Neurological involvement in endometriosis.

25/11/19

Dr Shamitha Kathurusinghe

Gynecologist Surgeon, Melbourne, Australie

British Society of Gynecologic Endoscopy written report to the committee.

Dear BSGE committee,

Thank you for granting a BSGE trainee travelling fellowship towards my training in Gynaecological endoscopic surgery. I had the wonderful opportunity to visit endometriosis expert Prof Horace Roman at his endometriosis centre in Bordeaux, France from September to October 2019.
During this travelling fellowship, I had the opportunity to immerse myself in advance laparoscopy dedicated to endometriosis under the guidance of professor Roman and his specialised multidisciplinary team. I was able to conclude my visit by fulfilling my travelling fellowship goals which included networking with many international colleagues.
During my visit, I was very interested in observing and learning about how the Bordeaux team apply the usual practices that are conducted in any operating theatre setting. I observed some variation in practice in comparison to the health services I worked in the UK and Australia. There is extensive care taken for antisepsis by Prof Horace’s theatre team. This allowed me to reflect on my current practice and the practice within my health service and whether there was an opportunity to improve. In comparison, Prof Horace’s patients have an overall infection risk of 10%. My reflection is that careful attention to skin preparation has contributed to a lower infection rate for such high-risk surgery where bowel viscus and vagina are often breached. There was also no overall variation in antibiotic regimes in his patients, compared to our study patients. Along with skin preparation, the surgical drape used by his team for surgery is a single drape that exposes the abdomen area and covers the patient from top to bottom in one single drape action, with an excellent adhesive band around the exposed margins. The use of a single drape may also reduce the chances of contamination that can occur with the application of multiple drapes at the start of the procedure. Furthermore, the use of airseal low-pressure pneumoperitoneum may also contribute to improved surgical outcomes.
Professor Horace is an excellent surgeon; however, he can achieve such excellence as a result of his dedicated team. The theatre team function very well, and all members are treated with absolute respect. The team display magnificent teamwork, that is the envy of any operating theatre in the world. There is also a mutual trust between everyone that they are all working well towards providing excellent patient care. Prof Horace is supported in theatre by the same wonderful scrub nurse for every single case, every day. The scrub nurse is highly skilled and very proactive and predicts every move prof Roman makes and is ready to hand instruments and sutures every time. Prof Roman has high respect for his theatre team, and if the theatre team questions anything concerning the surgery, he takes the time to ensures to listen and consider their questions and feedback, which acts as a safeguard for the patient.
Patients recover very well from the general anaesthetic following major surgery such as advanced endometriosis excision with bowel surgery which may include resections and stomas. Patients have excellent pain control and usually, mobilise early and even get discharged home soon afterwards. Other than excellent surgical practices, another contributor to proper pain management and early mobilisation is the pain management protocol that the anaesthetic staff use for endometriosis patients.
The pain protocol ensures that the patient has good baseline pain relief which is then titrated with prn medications. Opioid based analgesia is not the primary pain relief component. The numerical rating score (NRS) is used to guide patient and nursing staff to administer analgesia promptly to avoid exacerbation of pain. This pain protocol is accurately followed by all anaesthetic staff which ensure consistency in the prescription and administration of pain relief.
Many gynaecologists from all around the world come to see Professor’s work. During my time working in his clinic, I had the opportunity to network with colleagues from Paris, Israel, Jordon, Turkey and Morocco. It was an absolute pleasure to exchange notes in each others areas of expertise and share ideas and discuss interesting concepts in gynaecology. I have built friendship and professional networks which will no doubt become a valuable future asset.
I also had the opportunity to write up some research for professor Roman during my visit. Professor has extensively published in the area of bowel endometriosis. He has been using double disc resection to treat endometriosis nodules that are too large for single resection or when the integrity of the anastomotic suture of single disc requires strengthening. To date he has completed 22 such cases. Therefore, with his current fellow, I had the opportunity to review the data and analyse it and write an article for submission. I enjoyed reading further into bowel endometriosis and analysing his results against the current published evidence. I hope to continue to do more research with his team in the long term.
Professor Horace is very humble and genuine to everyone. He is very respectable in his approach and would never lose his temper or speak disrespectfully to the staff or patients. He is continuously innovating his practice. He is keen to learn and hear ideas and opinion from everyone, but most importantly, he shares his wisdom and knowledge with us. He performs live surgery regularly, and if he has a complication, he is transparent about it and takes careful measures to manage the complication by ensuring the patient is getting the best possible care. He is an excellent example of an excellent surgeon, and it was an absolute pleasure to do my travelling fellowship with him. I had the opportunity to learn many advance dissection skills and surgical procedure techniques from him and his team.
In conclusion, I received an excellent overview of the practices of a centre of excellence for endometriosis. I was able to reflect on not only the advance surgery aspects, but more importantly, primary surgical and patient care practises that I can improve on for my health service. I leave his unit with the hope of returning in the future.
Thank you,
Dr Shamitha Kathurusinghe

01/07/19

Ilyas Arshad

Consultant Gynaecologist, John Radcliffe Hospital, Oxford, Angleterre

British Society of Gynecologic Endoscopy written report to the committee.

With great excitement I drove to Bordeaux to spend a month immersed in deeply infiltrating endometriosis surgery. I must thank my Clinical Director, Ingrid, from Oxford to allow me to pursue my quest for further knowledge.
Professor Horace Roman’s hospitality and kindness showed no bounds. He had, at any given time any number of fellows and teams visiting him from all around the world. All with the same aim, to advance their knowledge of endometriosis surgery. During my stay, I met surgeons from the greats to the future of endometriosis surgery from Australia, Denmark, Italy, Jordan, Romania and of course the UK.
One of my aims was to see how Horace tackles severe endometriosis surgery of the colon, bladder, vagina, deep splanchnic nerves and the Diaphragm. I also wanted to gain an insight into the types of data he collects that allows him to make such a useful contribution to endometriosis research.
Horace uses advanced surgical equipment to excise all deep infiltrating endometriosis. I could see the significant improvement in depth perception with the aid of 3D laparoscopy especially when dissecting and excising rectovaginal nodules
The Plasmajet was able to create planes making ureterolysis and rectovaginal shaving look so effortless. The other advantages being ablation of endometriosis from bowel surfaces with minimal thermal spread and depth penetration. I also developed a deeper understanding of the delicate decision making when considering whether to carry out a disc excision, Rouen excision or when a segmental resection would be more appropriate.
Another learning point included the management of endometriomas, to minimise ovarian reserve damage. Horace would first drain the endometrioma and wash it out. He would then instil 95% alcohol within the endometrioma for 10-15 minutes. He explained, alcohol sclerotherapy destroys the epithelial covering of the cyst by coagulation necrosis, fibrosis covers the inner cavity and prevents reformation of the endometrioma in 91% of cases after 3 years follow up, whilst maintaining a natural pregnancy rate of 57%. The other technique is to drain the endometrioma evert the cyst wall and ablate this entirely 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 food festival. I enjoyed a night out with a team of surgeons from Italy. The whole experience was uplifting and inspiring. I returned to Oxford with a great desire and enthusiasm to implement positive changes to the management of endometriosis.

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Prof. Ishai Levin

Head of Gynecology Lis Maternity Hospital Tel Aviv Sourasky Medical Center President of the Israeli Society for Gynecological Endoscopy

Dear Horace,
I spent a few days in your center of excellence last year.
These were a few days filled with tremendous surgical experience, packed with at least 5 colorectal resections a day. An experience I never thought possible.
Participating in surgical procedures with both you and Benjamin I learned so much.
This wealth of knowledge, both surgical as well as medical has in my belief opened my eyes regarding the surgical management of endometriosis.
Future cooperation was as well possible with Benjamin giving a live surgical case for us at the Israeli Gyn Endoscopic society meeting held last February.
Also, I am grateful for new friendships both with you and Benjamin since my last visit.
At my center we are all waiting for this Covid-19 epidemic to be over so that we can come again..
When we parted I thanked you for my visit at the “Temple of Endometriosis”
This is what I think since.
I am forever grateful.

02/09/20

Dr. Prashant Mangeshikar

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 Prof Horace Roman,
Its almost 5 months since Abhishek and I spent a week at your Center of Excellence Clinique Tivoli Ducos for the one week workshop on Understanding Endometriosis.
The training that you imparted to us in recognising and treating advanced endometriosis via your lectures and the practical training that we received as observers and scrubbing for the cases in your operation theatre with a large number of cases of advanced endometriosis 22 to be exact in the 5 days in theatre opened our eyes to a simplified step by step approach to understanding the retroperitoneum , the disease : endometriosis and a systematic step by step approach to excise endometriosis. Your surgical skills are exemplary and the ability to share your knowledge and skills rightly places you on the pedestal of a PROFESSOR. It was an honour for me to be your student watching every step you made in the Operation theatre and you guided us to make the most difficult surgeries easier, predominantly focused on excision of gastrointestinal, urological and pelvic nerve endometriosis
Prof. Roman is a highly skilled and experienced endometriosis surgeon. He is internationally recognised and respected by his peers. I have watched from him, he does achieve complete excision of the disease, even in the most complex scenarios.
I would highly recommend that those who want to excel as expert endometriosis excisions surgeons should spend time to visit the Center and learn the pearls of wisdom from PROF HORACE ROMAN.
Hopefully, I plan to visit the Clinique as a student of Prof Roman once more,
Thanks once again
Regards
Prashant

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Jamil Marabha

Gynecologist surgeon, Aman, Jordanie

Dear professor Horace Roman
It just happened to me when I started following your videos through LinkedIn and YouTube , then I get lucky and my dream went real when I joined your good self and your great team finding myself working under your hands professor, throughout 18 months of hands-on training, I gained the greatest experience in my life by participating in more than 400 operations of the most difficult cases of Endometriosis ever seen worldwide , researches, articles, congresses, meetings, and consultations. I’m very proud that I joined you and your great team and colleagues Benjamin, Damien, and Mylène,
I never forget those golden days and every single moment of your precious time and your distinguished experience all my life ever.
Wishing you all the best
Sincerely yours…

17/08/20

Jaime Ocampo, M.D.

Gynecologist Surgeon, San Francisco, USA

Dear Professor Roman, I wanted to thank you for welcoming me to your center. Having the opportunity to observe one of the world experts in endometriosis live was delightful. I had been following you for a while online and have been amazed by the type of surgeries you perform. It was invaluable to watch the performance of a discoid resection. Observing in your operating room allowed me to see your set up and better understand the sequence of events that the surgery entails. I knew that the surgeries would be excellent what I was not expecting is your kindness and that of your team. You possess a genuine desire to teach and share your knowledge. I hope to be able to visit your center in the near future and this time for a longer period of time. Sincerely, Jaime Ocampo M.D.

18/8/20

Ralf Bends

Gynecologic Surgeon, Köln, Germany

Dear Horace, With great pleasure I would like to thank you for the opportunity to visit you in your Endometriosis Competence Center and participate in some of your procedures to gain an insight into advanced management of deep infiltrating endometriosis. As a long time endometriosis surgeon, it was a tremendous experience for me to get new impressions and an inside view of your „Rouen technique“, which I deem for a huge step forward in DIE surgery, as it definitely shortens duration of procedure and diminishes perioperative morbidity associated with convincing clinical results! As important as surgical techniques were the discussion and exchange about preoperative treatment and diagnostic procedures. All this was priceless in terms of bringing forth the efforts of my own work! Thank you for this meeting in hospitality and friendship – I’m looking forward to seeing you again and continue our joint work on endometriosis! Warm regards, Ralf Bends, Cologne/ Germany

21/11/18

Mr. Denis Tsepov, MRCOG

Consultant Gynaecologist Clinical lead for Harley Street BSGE Endometriosis Centre, The Harley Street Clinic, London, UK

It was a total pleasure to visit Prof. Horace Roman and his team in Bordeaux with my colleagues from The Harley Street Endometriosis Centre in London. We had a very warm reception and have seen a true high class laparoscopic surgery for severe endometriosis. We have seen and learned the pioneering technique of CDH stapler discoid bowel resection for endometriosis and during the last two years it has become the procedure of choice for suitable patients in our Centre.
We can not thank Prof. Roman enough for his professionalism and we are totally looking forward to meeting him in the operating theatre again either in Bordeaux or in London.

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Ahmet Namazov , MD

Gynecologist surgeon, Ben Gurion University, Ashkelon, Israel

I was in Bordeaux as fellow of Prof Roman Horace between September 2019- March 2020.
My fellowship program was planned to be until July 2020. But because of Covid19 outbreak it was stopped.
Although the program was finished earlier, I participated in more 150 surgeries , of them 100 colorectal endometriosis. This is huge number , that I think it is impossible to get such as experience during 7 months in any other centers.
I am very happy to be a fellow of Prof Horace Roman. Endometriosis Center in Tivoli, Bordeaux opened my eyes in the field of endometriosis. It changed my approach to the patients with diagnosis of endometriosis especially colorectal endometriosis.
Multidisciplinary meetings with radiologist were very interesting and teachable. During my fellowship I also learned to read MRI imaging in patients with endometriosis.
The center of Prof Horace Roman is also a research center. You can also participate in researches. During my training I wrote two articles about endometriosis.
Thanks to dear mentor Prof Roman Horace.
It was the most interesting training in my professional life.
I was in Bordeaux as fellow of Prof Roman Horace between September 2019- March 2020.
My fellowship program was planned to be until July 2020. But because of Covid19 outbreak it was stopped.
Although the program was finished earlier, I participated in more 150 surgeries , of them 100 colorectal endometriosis. This is huge number , that I think it is impossible to get such as experience during 7 months in any other centers.
I am very happy to be a fellow of Prof Horace Roman. Endometriosis Center in Tivoli, Bordeaux opened my eyes in the field of endometriosis. It changed my approach to the patients with diagnosis of endometriosis especially colorectal endometriosis.
Multidisciplinary meetings with radiologist were very interesting and teachable. During my fellowship I also learned to read MRI imaging in patients with endometriosis.
The center of Prof Horace Roman is also a research center. You can also participate in researches. During my training I wrote two articles about endometriosis.
Thanks to dear mentor Prof Roman Horace.
It was the most interesting training in my professional life.

15/07/20

Dr Jennifer Pontré

Consultant Gynaecologist, Perth, Western Australia

I completed a 4 week long observership at the Clinique Tivoli-Ducos in June 2019. This was an incredible experience, and I got a great deal out of it professionally and personally. Professor Roman is not only a highly skilled surgeon and prolific researcher, he is also a dedicated teacher and very generous with his time and knowledge. He and his team at the Clinique were welcoming and accommodating, and I was able to both observe and assist in theatre every day. At every possible moment he discussed and explained his techniques to maximise each teaching opportunity, often in several languages simultaneously. I was able to assist at surgeries where procedures such as the Rouen technique, disc excisions, bowel resections and dissection of the sacral nerve roots were performed, amongst other procedures. This was an unparalleled opportunity to observe Professor Roman performing complex and radical excisions of colorectal endometriosis, and was able to learn a great deal in a short period of time as up to 6 surgeries were performed each day. In addition, Bordeaux is a beautiful city filled with cultural, historic and gastronomic attractions, and is also the hub of the famous Bordeaux wine region. I cannot recommend a visit highly enough.

Dr Moshe Meshulam

Gynecologist surgeon, Tel Aviv, Israel

Dear Horace,
It has been already three months since I came back to Israel after my extraordinary year in France, and the power and energy that you gave me are still pushing me forward in full speed! Many people says that 2020 was a very bad year but for me personally, it led me to you, in retrospect, that was pure luck and the best thing that happened to me. With your teaching and guidance, you made me believe it’s possible! and when I came back to Israel I had both the professional knowledge and courage to present to my bosses here in Israel a detailed plan to open an endometriosis center in my hospital, and I’m so happy and proud to tell you that last week we officially opened our new endometriosis center which contains not only the surgical aspects but also the diagnostic part (US and MRI), the fertility aspect including fertility preservation and the long term treatment including a psychologist and pelvic floor physiotherapist. I did leave Bordeaux few months ago but I’m still learning a lot from you! following your YouTube channel and webinars, I feel almost like I’m in your operating room with you again :). So once again, thanks so much for everything, I’m proud to be your student and I’m looking forward to come visit you again, even for few days to learn and to enrich my knowledge as soon as the COVID situation passes.

Dernière mise à jour le Jan 15, 2021 @ 17:31