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What is a Surgical Center of Excellence?

Today’s buzz word is “Center of Excellence.”  What does that mean exactly and how is excellence defined. Currently, if you pay enough money, some organization will certify you to be whatever you want to be called. It can mean anything from paying money to someone to designate a program as a center with official logos etc., or there could be some certifying body that gives this designation to a program.  Currently there are no agreed standards to designate and the certifying bodies are self proclaimed groups.  Have you ever wondered how most hospitals in the area claim to be in the “Top 100 US Hospitals?”  For the thousands of hospitals in the US, it would be highly unlikely that three or four of the top 100 are here in Jacksonville.  The fine print usually reads, “by some designating body.”  Those are not official certifying groups and the designation is not binding in any way.  

Recently at a subsection meeting of the AAGL (Am Assoc of GYN Laparoscopists) a european surgeon compared the “center of excellence” idea of the Americans to the European designation of “Center of Expertise.”  In their model, Expertise was defined as a center where the surgeons had performed significantly more cases of a particular type, giving them the experience necessary to perform at the highest level available.  In the smaller European countries, a few centers for each disease serve the population.  It is also the european experience that surgeons who had that higher number of cases and inherent experience, did so as a result of their underlying surgical skill.  These centers then are the places where new techniques are continually developed.  

In independent surgical data that is commercially available, for endometriosis and minimally invasive reproductive and gyn surgery, our practice is operating at level 10 (out of 10), or the highest level in the country.  The Robotics company sought us out as a result to partner in the realm of teaching endometriosis resection to other gynecologic surgeons across the nation.  We attend national society meetings and promotional meetings where we see videos of the surgeries being touted as the most advanced available and it is clear that we are operating at that level and in many cases above these levels.  

Thus, as a matter of definition in this regard, we consider ourselves a Center of Surgical Expertise in Reproductive and Gynecologic Minimally Invasive Surgery.  Starting with Dr. Fox who pioneered much of the advanced technique with traditional laparoscopy for these procedures, and following with Dr.’s Lipari and Paschall who now have the experience and training to operate at this level, JCRM offers the highest level of Minimally Invasive Surgery available in the US.  As a group, we are continuing to develop new and better ways to do things and adopting techniques that truly add to the care of the patient and not just bringing fanfare to operating room.  We act as the patient advocate in evaluating new technology, instrumentation, and technique for the treatment of surgical disease.  

With all the advertising of medicine, both drugs, surgeries, doctors, hospitals and the like, it is nearly impossible for the average person to figure out the truth.  At JCRM, we commit to you, our patients, to provide the most advanced surgery available, in the safest possible setting, and to continue the evaluation of new ideas, techniques, and technologies incorporating them when it becomes clear they are first safe and second provide benefit.  

Surgical Procedures:


  1. Resection of Endometriosis
  2. Myomectomy
  3. Tubal Reversal
  4. Opening Blocked Tubes
  5. Repair Tubes / Adhesions
  6. Treatment / Removal Ovarian Cysts
  7. Outpatient Total Laparoscopic Hysterectomy
  8. Surgery for Birth Defects of Reproductive System
  9. Resection of Adenomyosis