Presentation on Dr. Demir\'s activities

1. Richard H. Demir, MD Director of Ultrasound, Gynecology & Obstetrics - Desert Women’s Care President -Society of Elite Laparoscopic Surgeons

3. Clinical Activities DWC… We care about patients!

4. Dr. Demir is proud of his commitment to Minimally Invasive Surgical principals and offers the most sophisticated procedures so open abdominal surgery can soon be relegated to history books DWC… We care about patients!

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8. DWC Minimally Invasive Surgery Program

9. Dr. Demir and DWC offer a full team commitment to performing and successfully completing even the most complex procedures using Minimally Invasive techniques. DWC… We care about patients!

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17. urethra bladder Dome of the Foley catheter Sutures suspend paravaginal tissue

21. Uretex® TO Trans-Obturator Urethral Support System Twenty Minute Repair for Stress Urinary Incontinence

22. TransObturator Approach as effective as open abdominal surgery with 1 – 2 day recovery time and virtually no time off work Enquire… your physician has no idea that you may have Stress Incontinence

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26. Pedunculated sub-serosal uterine myoma is clearly demonstrated at laparoscopy

27. Myoma is attached to the uterus on a stalk that is clearly identified

28. Once free within the abdominal cavity the myoma is morcellated and removed in long fragments

29. Excision of this myoma leaves a denuded area that is covered with an anti-adhesive barrier prior to concluding the procedure

31. Ultrasound demonstrates an abnormal mass within the ovary

32. The same mass is demonstrated on laparoscopy

33. Mass is removed and bleeding controlled Capsule is opened and mass shelled out Capsule of ovary is closed with absorbable sutures

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43. TM *Based on Intent-To-Treat population 1. Extirpated uteri data on file, ETHICON, INC. 2. Loffer FD, Grainger D. Five-year follow-up of patients participating in a randomized trial of uterine balloon therapy versus rollerball ablation for treatment of menorrhagia. J AM Assoc Gynecol Laparosc. 2002;9(4):429-435. 3. NovaSure. Instructions for Use © 2004, Cytyc Corporation 4. Cooper J, Gimpelson R, Laberge P, et al. A randomized, multicenter trial of safety and efficacy of the NovaSure system in the treatment of menorrhagia . J Am Assoc Gynecol Laparosc . 2002;9:418-428. 5. GYNECARE THERMACHOICE ® III. Instructions for Use. © 2008 ETHICON, INC. 6. Her Option ® . Instructions for Use. © 2006 American Medical Systems, Inc. 7. Hydro ThermAblator ® System. Instructions for Use. © 2005 Boston Scientific Corporation. 4 5 6 of menstrual bleeding or lower has a conforming balloon which leads to improved coverage, treatment and efficacy vs earlier generation GYNECARE THERMACHOICE® products 1 is introduced, providing a silicone balloon material and fluid circulation the first GEA device, is introduced 4

47. Ultrasound demonstrates a large fibroid tumor within the myometrium

48. Laparoscopy clearly demonstrates the enlarged uterus with irregularity of the fundus

49. Ligasure device is used to divide the attachments of the uterus

50. The bladder is located and moved out of the way to assure it is not injured

51. In Supra-cervical hysterectomy, the corpus is divided from the cervical stump

52. Once the body of the uterus is free, it must be morcellated so that it can be removed through the “pencil-like” abdominal incisions

53. The parietal peritoneum is sewn over the cervical stump sealing the abdominal cavity

55. Koh Colpotimizer Rumi Manipulator

62. Early decrease from Scope Hyst (LH) Early increase from Scope Hyst (LH) Late decrease from Scope Hyst (LH)

70. Anybody need some help here?

72. DWC Multidisciplinary Pelvic Pain Program

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83. Administrative Activities DWC… We care about patients!

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91. A full website is up and running for Desert Women’s Care. Communication with patients featuring text, photos and videos is available online. DWC… We care about patients!

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98. The “Raise The Flag” project returned the US flag to walton Island on the Fox River in Elgin

103. Publishing DWC… We care about patients!

104. Dr. Demir has over twenty peer-reviewed publications including articles, abstracts, videos and book chapters. DWC… We care about patients!

105. “ Laparoscopic Cervical Cerclage in 18 weeks Pregnant Uterus” was presented in June, 2010, at BICOG in Belfast, UK, and in September at SLS in New York City DWC… We care about patients!

106. Dr. Demir and Dr. Marchand won Honorable Mention GYN Video Award at 2010 Annual Meeting of Society of Laparoendoscopic Surgeons in New York City

107. Dr. Demir won 2010 Spotlight Award from Cooper Surgical for outstanding surgical video– SELS Laparoscopic Myomectomy

109. Teaching Activities

113. SELS Homepage

117. Two Kilo Club Homepage

119. This list encompasses all surgeons who have successfully qualified to be counted among the ranks of the two kilo club by successfully removing a uterus weighing greater than 1999 grams without resorting to laparotomy. Member list is updated monthly. Surgeons may apply by submitting official documentation in order to be considered immediately. In addition, TKC staff performs regular literature searches of reliable sources and data collection agencies in order to attempt to compile a comprehensive list of all surgeons internationally who have accomplished this feat. Two Kilo Club