The Mayo Clinic Fibroid Clinic offers a comprehensive approach to fibroid care, and is in a unique position to offer patients all available options for non-surgical and surgical treatment of fibroids.

As a fellow, you will have an opportunity to collaborate with Interventional Radiologists for patients desiring uterine fibroid embolization or focused ultrasound treatment, and will also be able to participate in the counseling and performance of gynecologic surgery for fibroids including:

• Radiofrequency ablation
• Myomectomy
• Hysterectomy

Depending on the fibroid burden, the approach to myomectomy may include laparoscopy, robot-assistance, mini-laparotomy, and in some cases a traditional open technique.

We expect fellows to be competent in the perioperative assessment and counseling as well as technical skills associated with these procedures.

As a fellow, you will participate in a multidisciplinary endometriosis care group where you will manage all stages of endometriosis and employ both medical management and surgery.

The program includes a collaborative endometriosis MRI imaging conference where radiology and gynecology review protocoled MRIs to refine the management plan for deep infiltrating disease.

Emphasis is placed on the preoperative workup to multidisciplinary surgery as well as the evaluation for other contributors of pelvic pain. Advanced endometriosis surgery, including deep endometriosis of the bowel, ureter, bladder, and diaphragm is completed primarily by the MIGS surgeons, with multidisciplinary coordination for deep endometriosis requiring resection of bowel and other organs as indicated.

The Mayo Clinic Chronic Pelvic Pain (CPP) clinic focuses on multidisciplinary care of these complex patients.

Utilizing a team-based approach, our team of advanced practice providers triage eligible patients followed by pre-visit planning to optimize their in-person visit. Our nurse practitioners see these patients along with the MIGS fellows and staff. 

Within Mayo, we work very closely with physical therapy, cognitive behavioral therapy specialists, internal medicine, gastroenterology, radiology, and the anesthesia pain clinic as needed to provide holistic care to our patients.

The Mayo Clinic MIGS division leads a robust hysteroscopy practice including high volume office hysteroscopy. More than 1,000 office hysteroscopies are performed annually, consisting primarily of flexible diagnostic procedures but also office operative polypectomy and removal of malpositioned IUD.

The office practice compliments the more complex operative hysteroscopy procedures performed in the operating room:

• Myomectomy
• Adhesiolysis
• Polypectomy
• Resection of septa

As a fellow, you'll have a unique opportunity to work with REI surgeons and a dual fellowship (MIGS and REI) trained physician, Zaraq Khan, M.B.B.S., during your surgical rotations. 

This collaboration provides unique exposure and surgical training in complex müllerian anomalies, tubal surgery, fibroid, and advanced endometriosis surgery, as well as cutting-edge ovarian tissue transplantation surgeries in women actively seeking fertility.

As a fellow, you'll practice targeted surgical techniques to help in maintenance of ovarian reserve or enhance fertility directly. 

By the end of the fellowship, you will be able to counsel a patient for surgical intervention versus referral for assisted reproductive techniques (ART) in women with benign gynecologic conditions who are otherwise actively seeking fertility.