She's Back on Her Toes

While other doctors danced around a diagnosis, LVHN surgeons were en pointe and able to take away pain that afflicted Gianna Tolotta, a Lehigh Valley native and professional ballerina

Jetés, pliés and pirouettes have filled 18 of Gianna Tolotta’s 21 years. It’s no wonder that the Bethlehem Catholic graduate is now a professional ballerina. Yet just as her career was gaining momentum, Tolotta found herself slowing down.

“It was audition season, and I was having this cramping pain in my abdomen,” Tolotta says. She pushed through the pain and landed a summer contract dancing at the American Contemporary Ballet in Los Angeles, as well as a contract for Colorado Ballet’s 2017-2018 season.

“I just remember the pain getting worse through every movement,” she says. “I had sharp pains, aching pains, internal itching sensations and continuous cramps. On some days I felt like I couldn’t even get out of bed.”

Act 1: Hidden pain revealed

She visited doctors in California, who theorized she might have a hernia or possibly endometriosis. They recommended surgery to include a meshless hernia repair, but Tolotta wanted a second opinion. So she booked an appointment with surgeon Martin Martino, MD, LVPG Gynecologic Oncology, whom her mother and aunt had previously seen for surgical procedures, and flew back to the Lehigh Valley to see him. 

While imaging at LVHN did not reveal a hernia, it’s what Martino suspected. He recommended a minimally invasive surgery using the da Vinci® Xi™ robotic surgery system. Xi provides 3D imaging that could help determine the source of her pain. The system would also provide a minimally invasive way for Martino to correct it.

Act 2: Precision care restores order

Martino consulted with surgeons T. Daniel Harrison, DO, and Scott Beman, MD, both with LVPG General, Bariatric and Trauma Surgery and members of the LVHN robotic surgery team. They discussed how surgery could likely restore Tolotta’s full range of motion and take away her pain, while at the same time provide a cosmetically pleasing outcome that would not affect her career as a ballerina or ability to have children in the future.

During Tolotta’s August 2017 surgery, Martino discovered that her pain was from an inguinal hernia in her right lower pelvis, exactly where she had pinpointed her pain source.  “If you had a small balloon and you pushed it out through a very small window in the abdomen to create an opening, that is a hernia,” Martino says. During surgery he also discovered other conditions that were likely contributing to her pain beyond the hernia. 

In addition to having endometriosis, a condition where endometrial tissue from inside the uterus grows on the outside of a woman’s reproductive organs, Martino discovered that Tolotta also had adhesions in her abdomen near the hernia. He hypothesizes that the adhesions – bands of scar tissue that can bind organs and other tissue together in a painful way – had likely developed around her hernia as a way of her body trying to heal itself.

Act 3: Free from pain, dancing again

“We were able to remove the endometriosis, close the hernia defect and reconstruct the area where Gianna had her major symptoms,” Martino says. “We did this all with just a few small, hidden scars.”

“I have three tiny scars that you can barely see,” says Tolotta, who before the surgery wasn’t able to do even the most basic ballet moves. She’s now dancing full time with the Colorado Ballet in Denver. “In ballet, we train our bodies to move in ways the human body isn’t set up for, such as building strength in the alignment with your hips 180 degrees open, or the pressure of all your body weight on your toes. I’m excited to finally be back doing full-length rehearsals and performing with no pain.”

Martino describes Tolotta as an elite athlete. “We know how to care for athletes, and all our patients, when stakes are high,” he says. “As an elite athlete, Gianna could have gone anywhere in the country, but chose to come back home to LVHN. We are thankful she trusted our team with her care."