Robotic Surgery - Amazon S3€¦ · Robotic surgery is performed through tiny incisions, leading to...
Transcript of Robotic Surgery - Amazon S3€¦ · Robotic surgery is performed through tiny incisions, leading to...
Robotic Surgery: A new option for quicker recovery
Noninvasive cardiac imaging page 7
Repairing a broken heart page 6
Events, classes and support groups page 4
2011SUMMER
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But today, these computer-enhanced marvels are helping to make minimally invasive surgery even less invasive.
Long Beach Memorial recently purchased its second robotic system. “This new acquisition prepares the hospital for the growing number of cancer surgeries performed with this leading- edge technology,” says Judy Fix, R.N., senior vice president of patient care services. “It also makes the MemorialCare Heart and Vascular Institute one the nation’s leading centers for robotic surgery west of the Mississippi.”
IncredIble PrecIsIon Known as the da Vinci® S. Surgical System, the robot is controlled by the surgeon. Operating
the machine from a console a short distance from the patient, the doctor uses a joystick- like handle to move the robot’s arms, wrists and fingers, which are equipped with a miniature video camera and tiny surgical instruments. Each movement of the surgeon’s hands is translated into precise, real-time movements by the robot. And since the robot’s “wrists” have a 270-degree range of motion, surgeons are able to perform micro-manipulations in small, often hard-to-access areas of the body.
Additionally, the robot’s viewing system produces high-definition, 3-D images, allowing the surgeon
to see inside the patient in unprecedented detail. The result is a very precise surgery performed through very small incisions. “The robot represents a significant advance over laparoscopy, a minimally invasive technique that uses rigid instruments and 2-D imaging,” says Fix.
For heart patients, the benefits of robotic surgery are numerous, including the elimination of a 10- to 12-inch chest incision. Instead, thanks to the robot’s manual dexterity and 10-power imaging system, doctors are able to access the heart through a few tiny incisions between the ribs. And there’s more good news: In most cases, there’s no need for a machine to take over the function of the heart and lungs when the robot is used. This
revolutionary approach to surgery results in less pain for the patient, reduced blood loss, minimal scarring, a shorter hospital stay, faster recovery and quicker return to normal daily activities.
AdvAnced HeArt surgery One of the most common
robotic-assisted heart
For years, the only roles robots played were in science fiction thrillers.
Robotic Surgery: A new option for quicker recovery
LO N G B E AC H M E M O R I A L • S U M M E R 2 0 1 1
procedures performed at Long Beach Memorial is mitral valve surgery. When the mitral valve, which controls blood flow to one of the lower chambers in the heart, doesn’t close properly, blood can back up into the lungs. This makes the heart work harder and increases the risk of heart failure. Known as mitral valve prolapse, the condition can be corrected by either repairing the valve with the patient’s own tissue or replacing it with an artificial valve. Both approaches are among the most complex surgeries performed by cardiothoracic surgeons.
Robotic surgery is performed through tiny incisions, leading to quicker recovery and minimal scarring.
Long Beach Memorial cardiothoracic surgeons have also been leaders in the development of robotic beating-heart coronary artery bypass surgery. The operation is performed through three small incisions, while the chest is closed and the heart is beating. The robot also is used to insert pacemakers, correct certain congenital heart defects, remove cardiac tumors, correct the chaotic heart rhythm of atrial fibrillation, and repair atrial septal defects—holes in the wall separating the top two chambers of the heart.
A growIng lIst And the list of robotic procedures continues to grow—not only in the field of cardiothoracic surgery, but in other areas such as cancer surgery. For example, Long Beach Memorial surgeons use the robot to treat cervical, early-stage ovarian and endometrial cancer—all of which typically require a hysterectomy. With conventional surgery, the incision for a hysterectomy extends from the pubic bone to just above the belly button. But a robotic hysterectomy is performed through four or five tiny openings, resulting in a faster return to everyday activities.
Among the many urologic procedures performed robotically is the prostatectomy, or removal of a cancerous prostate gland. Due to its precision, the robotic-assisted prostatectomy significantly surpasses other surgical methods and is particularly notable in the post-surgical restoration of urinary control and preservation of sexual function.
Robotic surgery is also the latest breakthrough in minimally invasive surgery for colorectal cancer. Precision is especially important when operating in the pelvis, which houses blood vessels and nerves that must be preserved to ensure a patient’s quality of life. Patients undergoing robotic surgery for rectal or colon cancer typically resume a normal diet and bowel function faster than patients who have had conventional surgery. They also go home sooner and return to normal activities faster.
MInIMAl scArrIng The robot is also improving the prospects for people who need surgery for head and neck
cancer. This includes cancer of the thyroid, throat, tonsils, larynx (voice box), pharynx and tongue. For many years, traditional open surgery was the standard—an approach that came with the risk of significant scarring or disfigurement. But the robot allows surgeons to access the target anatomy with greater precision through five small incisions—or no incisions at all, in the case of throat cancer.
Lung cancer patients have also experienced the benefits of the robot. Unlike a thoracotomy, the traditional way of accessing the lungs that requires an 8- to 10-inch incision between the ribs, the robotic version of the operation is performed through a few tiny openings.
What type of surgery—open, laparoscopic or robotic—depends on a patient’s particular condition, general health and other factors. For a referral to a Long Beach Memorial physician using this technology, call 1-800-MEMORIAL or visit memorialcare.org/davinci.
LO N G B E AC H M E M O R I A L • S U M M E R 2 0 1 1
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nutritional counseling Mondays and Tuesdays, by appointment only
Do you need guidance with weight-loss
strategies, diabetes management or help with
a special diet? Join Becky Gerl, clinical dietitian
and certified diabetes educator, for a one-on-one
session. Call (562) 933-0524 for an appointment.
Fee required, some insurance accepted.
tai chi chih Thursdays, 4 - 5 p.m.
Chinese exercise for the mind and body.
Call (562) 933-1650 for more information.
Cost: $5 per session or $24 for six-week session.
living with Heart Failure Tuesdays and Thursdays, 1 - 3 p.m.
Patients diagnosed with chronic heart failure
are invited to join these sessions presented by
the MemorialCare Heart and Vascular Institute.
Held in the Cardiac Rehabilitation Gym. Call
Pat Long at (562) 933-3716 for more information
and registration. Free.
“the Inspirations” Fourth Thursday of every month
11:30 a.m. - 12:45 p.m.
A support group for persons living with chronic
lung disease. Held in the Outpatient Pulmonary
Rehabilitation Center Conference Room,
2840 Long Beach Blvd., Suite 210. Facilitated by
Cynthia Hinderberger, R.C.P., at (562) 933-5864.
HIv Pre- and Post-testing We offer free HIV pre- and post-test counseling
services by appointment. Call (562) 933-8590
for more information and location.
Peripheral Arterial disease (PAd) screening The MemorialCare Heart and Vascular Institute
offers a noninvasive PAD screening for $75. Call
(562) 933-3296 to schedule an appointment.
women’s cardiac risk screening The Center for Women’s Cardiac Health and
Research provides comprehensive cardiac risk
screenings for $55. Call (562) 933-2460
to schedule an appointment.
brain Injury support group Third Thursday of every month, 5 - 6 p.m.
Meeting held at the Transitional Rehabilitation
Services house. Support group is open to both
persons with brain injury and their families. To
RSVP, call (562) 933-1680 by the Monday before
the meeting. Free.
stroke…A-trial Fibrillation—Are you at risk for a stroke with A-Fib? Wednesday, June 29, 1:30 - 3:30 p.m.
Long Beach Petroleum Club Terrace Room
Learn about the effects of atrial fibrillation
and the risks for stroke associated with it. Free
cholesterol and glucose screenings available to
those who register early. Call (562) 922-0520.
stroke and depression—learn to cope with your depression Wednesday, Aug 31, 1:30 - 3:30 p.m.
Long Beach Petroleum Club Terrace Room
Learn how depression can increase your risk
factors and how you can prevent stroke. Free
cholesterol and glucose screenings available
to those who register early. Call (562) 922-0520.
stroke and stress…Are you at risk with too Much stress? Wednesday, July 27, 1:30 - 3:30 p.m.
Long Beach Petroleum Club Terrace Room
Learn how stress can increase your risk factors
and how you can prevent stroke. Free cholesterol
and glucose screenings available to those who
register early. Call (562) 922-0520.
stroke survivors support group First Monday of every month, 4 - 5:30 p.m.
A support group offering education, support
and hope for stroke survivors. Group is lead by
a rehabilitation social worker. To register, call
(562) 933-9034 one week prior to the meeting.
Held in the MemorialCare Rehabilitation Institute
dining room, Memorial West. Free.
Adult bereavement group Wednesdays, 3 - 5 p.m.
Doctors’ Conference Room 2
Thursdays, 6 - 8 p.m.
Radiation/Oncology Conference Room
Support group open to anyone over the age
of 18. No pre-registration required. Facilitated
by Rev. Diann Davisson. Call (562) 933-1450 for
more information.
Amputee support group First Thursday of every month, 11 a.m.
Learn and share with other amputees.
Educational and fun with great peer support!
Contact Ronda Oaks at (562) 420-2330. Free.
Perinatal loss support group Second and fourth Monday of every month, 7 p.m.
This group is open to anyone who has
experienced the loss of a baby from early
pregnancy, miscarriage, stillborn or newborn
death. Held in the Radiology/Oncology
Conference Room. Facilitated by Rev. Sharon
Yagerlener. Call (562) 933-1454 for more
information.
smoking cessation The MemorialCare Todd Cancer Institute
provides ongoing smoking cessation support
and information. One-on-one support may
also be provided pending insurance. Call
(562) 933-0961.
spinal cord Injury support group Second Monday of every month, 5 - 6:30 p.m.
Celebrate successes and share resources. Group is
lead by a rehabilitation social worker. To register,
call (562) 933-9034 one week prior to the meeting.
Held in the MemorialCare Rehabilitation Institute
dining room, Memorial West. Free.
general Adult volunteers We encourage adult men and women from our
community to join hands with us and make a
difference. Call the Volunteer Resources Department
at (562) 933-1624 for more information.
Memorialcare todd cancer Institute “wings” volunteer Program “Wings” volunteers provide support, comfort,
care and gifts for cancer patients and their
families. Orientation and training are provided.
To become part of our team as a TCI “Wings”
volunteer, contact the Community Outreach
Department at (562) 933-0961.
The following classrooms are located inside Long
Beach Memorial, 2801 Atlantic Ave.: Classrooms
1 and 2, Houssels Forum, Radiation/Oncology
Conference Room, Cardiac Rehabilitation Gym,
Human Resources Conference Room, MemorialCare
Center for Women and MemorialCare Rehabilitation
Institute. For directions, visit memorialcare.org
and click on “Locations.” For class information,
visit memorialcare.org/classes.
Parking card Get unlimited parking for a year when you
join the Senior Plus program for $25, renewals
$20. Parking cards can be purchased in the
MemorialCare Rehabilitation Institute lobby
Monday through Thursday from 8:30 a.m. to 4 p.m.
Call (562) 933-1650 for more information.
Medicine, Munchies and Movies Saturdays, Sep 24, Oct 15, Nov 19, Dec 10,
Noon
Join us for a monthly informational health
lecture, complimentary lunch and movie. Every
month a new health topic will be highlighted.
Call (562) 933-1650 for more information and
a required reservation.
save a life. donate blood today. At Long Beach Memorial and Miller Children’s
Hospital Long Beach, more than 1,000 units
of blood are used every month in lifesaving
procedures. You can help save the life of
someone right here in your community. Call
(562) 933-0808 to schedule an appointment.
beat the odds in cancer treatment This program offers research-based strategies
for improving quality of life, symptoms and side
effects to achieve positive-impacted survival
after a cancer diagnosis. The program was
developed and is conducted by physicians.
Call (562) 961-0155 for more information.
breast cancer Mentors Peer-mentoring group for newly diagnosed
breast cancer patients who will be matched with
breast cancer survivors. Call (562) 933-7815 for
more information.
cancer Answers Monday through Friday, 8:30 a.m. - 5 p.m.
This cancer helpline is designated to meet the
needs of cancer patients and their families.
An experienced oncology nurse responds to
your questions about treatment options and
cancer resources. Call (562) 933-0900 for more
information.
cancer Patient and Family support group Wednesdays, 6 p.m.
Sponsored by The Wellness Community. Call
(310) 376-3550 for more information. Meets in
MemorialCare Rehabilitation Institute. Free.
Kids, tweens and teens Monthly, 5 - 6:30 p.m.
A free support group for children whose parent
or significant person in their lives has been
diagnosed with cancer. The group meets once
a month and participants are broken into three
different age groups. Call (562) 933-0900 for
more information.
look good…Feel better at long beach Memorial Sponsored by the American Cancer Society,
the Look Good…Feel Better program provides
workshops for women undergoing cancer
treatment. Participants receive instruction on
makeup application and skin care provided by
trained volunteers and licensed cosmetologists.
Call (562) 933-0900 for more information.
newly diagnosed breast cancer support group Wednesdays, 4:30 - 6 p.m.
Held in the Radiation/Oncology Conference
Room. Call (562) 933-7845 for more information.
ovarian and gynecological cancer support group First and third Tuesdays of each month, 4:30 - 6 p.m.
A support group for women with ovarian and
gynecological cancers. Call (562) 933-0900 for
more information.
Prostate cancer support group Fourth Tuesday of every month, 6:30 - 8 p.m.
Sponsored by US TOO. Call (562) 933-0900 for
more information.
women guiding women A peer-mentoring program for newly diagnosed
gynecologic cancer patients who will be
matched with a trained gynecological cancer
survivor. Call (562) 933-7815.
Adult Insulin-Pump support group Second Monday of every month, 6:30 - 8 p.m.
Support group for adults with diabetes who are
using insulin pumps. Facilitated by Linda Kerr,
R.N., C.D.E., (562) 933-5070. Significant others are
welcome. Held in fifth floor classroom. Free.
living with Arthritis Second Wednesday of every month, 10 - 11 a.m.
Learn what you can do to manage your arthritis
and all about the available treatment options.
Held at Long Beach Memorial in the Human
Resources Classroom (ground floor). Call
(562) 933-9090 to register.
team spirit breast and ovarian
cancer 10K walk
Saturday, Sep 24
Check-in opens at 6:30 a.m.
Walk begins at 8 a.m.
Help win the fight against breast and
ovarian cancer by participating in the 2011
Team Spirit Breast and Ovarian Cancer 10K
Walk on Saturday, September 24 starting at
8 a.m. To be a part of Team Spirit, register
online at teamspiritonline.org or call
(562) 896-4037. For sponsorship, contact
Michele Roeder at (562) 933-1671.
sPecIAl events
screenIngs
stroKe volunteer oPPortunItIes
exercIse
HeArt
dIAbetes
Even
ts & C
lasse
s
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suPPort grouPs
lung
southern california Patient & Family centered care
conference
Friday, June 24, 8 a.m. - 4 p.m.
This conference has been planned to
provide a local opportunity for hospital
staff, administrators, as well as patients
and family members to come together in
interdisciplinary teams to learn, develop
and share skills in Patient & Family Centered
Care (PFCC). Community members and
families with hospitalization experience are
encouraged to attend for a discounted rate.
For more information, visit pfccpartners.com.
educAtIon
5
cAncer cAre
Are you or someone you know experiencing
foot drop as a result of a stroke and are
the age of 18 or older? If you meet the
requirements for participation, you may
able to participate in a research study at
Long Beach Memorial. For more information,
please contact Wendy Lazouras, DPT at
(562) 933-9032.
LO N G B E AC H M E M O R I A L • S U M M E R 2 0 1 1
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Today, the Los Osos resident continues to accrue frequent flier miles commuting to Europe and Asia. But when he learned he had a potentially serious heart condition, Jerald sought help closer to home.
The 62-year-old’s medical odyssey began in 2010 when he was found to have a leaky mitral valve. The valve, located between the heart’s upper left chamber (atrium) and lower left chamber (ventricle) is composed of two flaps called leaflets. The flaps are designed to close tightly when the ventricle contracts. This prevents blood from flowing back into the atrium. If the leaflets don’t seal completely—a condition called prolapse—blood may leak into the atrium and up to the lungs. “Most prolapsed valves don’t need treatment,” explains
Daniel Bethencourt, M.D., a renowned cardiothoracic surgeon and director of cardiac surgery at Long Beach Memorial. “But if a person has a severe leak or symptoms such as shortness of breath, the damaged valve may need to be surgically replaced or repaired.”
A new oPtIon Until recently, the only option for people with mitral valve disease was open heart
surgery. This requires a 10- to 12-inch incision in the chest, splitting
the breastbone, and spreading the ribs to
access the heart. Recovery from the procedure is slow—as much as three months or more. The return to normal
activities may take even longer.
Robotic surgery is a state-of-
the-art option for mitral valve prolapse.
“I wasn’t ready to be sliced open,” Jerald explains. “I’m very active; I do yoga and
Pilates and compete in martial arts here and abroad. I travel constantly. I didn’t want to be sidelined for weeks or months.”
robotIc exPertIse On his cardiologist’s recommendation, Jerald investigated two major medical centers offering robotic surgery. Then he did some due diligence of his own. “That’s when I learned about Long Beach Memorial and the Bethencourt Group,” he says. “I immediately knew that’s where I wanted to be.”
Tests at Long Beach Memorial showed that Jerald had damage to the leaflets, which prevented them from closing properly. He also had ruptured cordae tendineae—bands of tissue that connect the mitral valve to tiny muscles in the heart. Signals sent from these muscles to the cordae tendineae cause the mitral valve to open and close. “Think of the mitral valve as a tiny parachute,” Dr. Bethencourt says. “The cordae are like the parachute’s guide wires. In this case, both the parachute and guide wires were broken.”
unPArAlleled AccurAcy Fortunately, Jerald was an ideal candidate for robotic surgery. “The surgeon is in control of the robot at all times, but the machine’s wrists and fingers are more flexible and precise than human hands,” Dr. Bethencourt says. “Robot-assisted surgery allows doctors to view the heart in exceptional detail and to operate with unparalleled accuracy through very small incisions.” The benefits for patients are significant: less blood loss, a shorter hospital stay, faster recovery, and greatly reduced pain and scarring.
Jerald was in the hospital just 48 hours. The day of his release, he drove from Santa Barbara to Los Osos—a trip that would have been unthinkable after open heart surgery. And he’s been to the gym and Pilates class every day since.
“I couldn’t be happier,” he says. “I have no ill effects whatsoever. And the treatment I received from the care team at Long Beach Memorial and the Bethencourt Group was superb. If you told me I had to pay a million dollars for my surgery, this is still the place I would choose.”
For a referral to a Long Beach Memorial cardiologist, call 1-800-MEMORIAL or visit memorialcare.org/doctors.
During his 31 years directing Japanese commercials, Jerald Downen lived and worked all over the world.
Robotic Surgery Repairing a broken heart
LO N G B E AC H M E M O R I A L • S U M M E R 2 0 1 1
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And just like any other engine, it needs proper maintenance and care to work efficiently and remain in good condition.
MemorialCare Heart and Vascular Institute (MHVI) at Long Beach Memorial is ranked in the top 1 percent of California’s 600 hospitals for cardiovascular care. As national leaders in advanced, noninvasive cardiac imaging technology, MHVI heart specialists evaluate thousands of patients each year to determine their risk of heart disease and provide preventive strategies. “An ounce of prevention is worth a pound of cure,” says Gabe Vorobiof, M.D., MHVI medical director of noninvasive cardiology and cardiac imaging. “Early screening can identify potential problems soon enough so patients can benefit from effective preventive care.”
The leading cause of death in the U.S., heart disease is generally referred to as a “silent killer” because a heart attack is often the
first symptom a patient experiences. MHVI offers a range of diagnostic tests that can determine the type and extent of heart disease present. The choice of which tests to perform depends on a patient’s risk factors, history of heart problems and current symptoms.
testIng tHe HeArt Among the noninvasive tests that focus on early screening and prevention is the coronary calcium score. This five-minute exam is performed on a computed tomography (CT) scanner and can show the presence, location and extent of calcium deposits on the inner walls of the coronary arteries—a signal of heart disease.
A carotid intima-media thickness (CIMT) ultrasound
uses high-frequency sound waves to capture images of the movement and speed of blood through the carotid arteries—the large arteries on either side of the neck— as well as the amount of plaque buildup. “The carotid arteries provide us with a window into the condition of the coronary arteries, which is very useful in predicting future cardiovascular risk,” says Dr. Vorobiof.
Echocardiography uses sound waves to monitor the heart’s pumping capacity and synchronization. When used in conjunction with an exercise stress test, it can identify blood flow blockages caused by coronary
artery disease. And in a computed tomography coronary angiogram (CTA), a contrast dye is used to detect areas of arterial narrowing in the coronary arteries in a completely non-invasive fashion.
For patients with known or suspected heart disease, advanced imaging can be used to conduct further evaluations. Cardiac MRI, which produces three-dimensional views of the heart muscle and arteries, is especially helpful for assessing areas damaged by a heart attack. A 3-D echocardiogram can provide dynamic, detailed images that can help determine the condition of the heart’s valves, among other things. And positron emission tomography (PET) can measure blood flow in the heart and identify viable areas that have been damaged by a heart attack but are still capable of recovery. When combined with CT, PET can provide a comprehensive look at the structure and function of the cardiovascular system.
eArly dIAgnosIs Key Depending on a patient’s diagnosis, treatment strategies may include lifestyle modifications and medication such as cholesterol-lowering medications. If significant heart disease is found, more invasive therapies may be necessary such as angioplasty or surgery.
Early diagnosis and treatment of heart disease have proven to be effective. In the past decade alone, the death rate from heart disease has declined by more than 25 percent. “Our focus will remain on providing patients with the most innovative cardiac care available—and identifying heart disease early, when it’s most easily treated,” he says.
For referral to a Long Beach Memorial cardiologist, call 1-800-MEMORIAL or visit memorialcare.org/doctors.
Weighing less than a pound and averaging the size of a clenched fist, the heart is the engine of the human body.
Noninvasive Cardiac Imaging Getting to the heart of the matter
Gabriel Vorobiof, M.D., is medical
director of noninvasive cardiology,
heart failure and cardiac imaging
at the MemorialCare Heart and
Vascular Institute.
NON-PROFIT ORG.
U.S. POSTAGEPAID
PERMIT NO. 394LONG BEACH, CA
Long Beach Memorial is a not-for-profit, community-based hospital. It is part of
MemorialCare, which also includes Miller Children’s Hospital Long Beach, Orange
Coast Memorial and Saddleback Memorial in Laguna Hills and San Clemente.
1-800-MEMORIAL • memorialcare.org
2801 Atlantic Avenue • Long Beach, CA 90806
Help win the fight against breast and ovarian cancer by participating in the 2011 Team Spirit Breast and Ovarian Cancer 10K Walk on Saturday, September 24 starting at 8 a.m. Team Spirit brings friends and families together to raise money for breast and ovarian cancer research, diagnosis and treatment at Long Beach Memorial. Team Spirit was founded in 2000 as a small grassroots organization on the belief that more can be done to help fight and raise awareness of breast and ovarian cancer in the community.
The 2010 Team Spirit Walk raised $210,000— putting the total amount raised since 2000 to more than $1 million dollars. Be a part of Team Spirit. Register online at teamspiritonline.org or call (562) 896-4037. For sponsorship, contact Michele Roeder at (562) 933-1671.
Be a Part of Team Spirit
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Learn more about local health
events, the latest medical technology
and procedures, and how to lead
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YouTube to join the conversation.Members of the Memorial Medical Center Foundation and
Team Spirit participants celebrate their fundraising efforts
for ovarian and breast cancer.
Long Beach Memorial Named Best Regional Hospital
Named one of “America’s Best Regional Hospitals” by U.S. News and World Report,
Long Beach Memorial has been recognized for excellence in the following specialties:
cancer; heart and heart surgery; gynecology; orthopedics; neurology and neurosurgery;
gastroenterology; geriatrics; diabetes and endocrinology; ear, nose and throat; kidney
disorders; pulmonology; and urology.
2010-2011
LOS ANGELES, CACANCER 2010-2011
LOS ANGELES, CA