Richard Rosenfield MD

60E92197-3B3C-43C9-86A1-F175CAE9EA1C-1
60E92197-3B3C-43C9-86A1-F175CAE9EA1C-1

Richard Rosenfield MD

Seeing patient in Portland and Seattle

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Overview

60E92197-3B3C-43C9-86A1-F175CAE9EA1C-1
60E92197-3B3C-43C9-86A1-F175CAE9EA1C-1
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25 years in practice, trained at Stanford under some of the biggest names in endometriosis surgery in the 90’s (yes a while back!)

Outpatient based program, so while we do a ton of advanced endometriosis excisional surgery, if there is a known need for a bowel resection or diaphragmatic excision requiring hospitalization, we work with a hospital based team in Portland to arrange exceptional care.

Online Consult Available?
Yes

At a glance

Gender
Male
Education
Stanford trained MIGS surgeon, Excision expert, multi-disciplinary team. In Network with most insurance (Portland program- Pearl Women's Center). Out of network but affordable program via Transform Health in Seattle.
Affiliations
Oath Surgery Center - Portland ; Transform Health - Seattle
I completed my Endometriosis Fellowship under ___________
completed training before fellowship, but was fellowship site director with Portland Legacy Health MIGS program
Awards & Recognitions
AAGL Board of Directors
Mutliple Publications and speaking engagements over the years
Portland OR "TOP DOCS" 4 years in row
Insurance Accepted
all commericial plans

Endometriosis Surgeon Questionnaire

What percentage of your patients have endometriosis?
75
Do you practice obstetrics?
no
In 40 words or less, how do you treat endometriosis? How do you approach adhesions?
Optimal restoration of anatomy with miminal tissue trauma and excision of all visible disease, followed by multi-disciplinary follow-up as needed for recalcitrant symptoms, including but not limited to metabolic/gut, naturopathic and holistic remedies, including use of cannabinoids and novel new therapies.
If you excise endometriosis, what is your goal for a sufficient margin size? If you use other methods of removing or destroying endometriosis, how do you approach this and under which circumstances?
safe and wide is my mantra for exicsion
On the scale of 1 (less experienced (I rarely treat/ mostly refer out)) to 5 (extremely experienced (the majority of my cases)) how would you rate your current experience level and comfort with stage 3/4 endometriosis and complex cases?
5
What is your opinion regarding GnRH agonists and antagonists? What is your opinion regarding hysterectomies?
I don't prescribe or recommend these medications as primary treatment, but will consider if patient has ongoing pain after optimal excision.
Laparoscopic Hysterectomy certainly has its place, especially in patients who are not preserving fertility with uterine issues (tender cervix, abnormal bleeding, adenomyosis). But it's not a cure for endometriosis as I am certain all folks on this site know :)
What is your opinion on using Robotics (ie DaVinci) for the treatment of endometriosis? Do you use it?
We have a Davinci robot at our west side location and many surgeons prefer (and some are dependant on the technology) - that said, robotics will not make a bad surgeon, but can make a great surgeon better.
I prefer the use of straight stick laparoscopy as many of our international colleagues utilize, as the haptics and high quality optics are more important for me than wristed instruments.
Until we implement Ai and automation, the robotic platforms will continue to evolve, but the anatomical knowledge, clinical judgement, surgical wisdom, and meticulous technique define success.
Do you work with and/or refer patients to other healthcare providers? If so, which types (e.g. physical therapists, nutritionists, etc.) ?
yes and many
GI, gen surg, naturopaths, PFPT, dieticians, acupuncture, and more
How do you approach the following: bowel cases, urinary cases, thoracic cases and any other extragenital cases?
if known bowel invasion or thoracic endo, I refer to our hospital based colleagues-
preop MRI is not perfect, but this along with careful history has been very helpful for appropriate planning.
Do you follow up with patients at regular intervals post-operatively? If so, what are your findings?
we follow up with all of our patients
data collection is an ongoing project with OATH surgical
As much as we all hate to see it, some patients do have recurrence and we must address each patient based on individual goals and needs.
What percentage of your patients require re-surgery? How do you track this?
this is hard to track in private practice to be honest, but I would mention the younger patients (under 25 at first surgery) in my experience have a higher chance of a repeat trip to the OR. Ideally, surgery is "one and done"-
Do you have any studies, talks, or publications you'd like to share?
No
What are some fun facts about you? Hobbies, interests, family life, languages, etc. that you would like to share to help patients get to know you as a person?
I've been living in the Pacific Northwest since 2000.
My wife Rose and I love to travel in our van, I adore the outdoors from camping to hiking to skiing. I am a bit of a foodie, and I love music. I also play guitar and sing in a "jam band" in my free time.
I love what I do, and 2 of the most amazing parts of my work are helping couples achieve pregnancy esp in the face of endometriosis, and curing patients of debilitating pain.

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