The George Washington University Hospital Health News
Spring 2009

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Spotlight on Minimally Invasive Procedures
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The George Washington University Hospital Health News

The George Washington University Hospital Health News


Spotlight on Minimally Invasive Procedures

The GW Minimally Invasive Surgery Center at The George Washington University Hospital is leading the Washington, DC, area in providing more laparoscopic surgery options than ever for both common and complex conditions.

Photo of Khashayar Vaziri, MD
Khashayar Vaziri, MD, Assistant Professor of Surgery
Chronic Heartburn? Or Is It GERD?
Chronic heartburn, nausea and regurgitation could be symptoms of gastroesophageal reflux disease (GERD). This condition occurs when the oneway valve at the end of the esophagus doesn't close properly, and stomach contents and harmful gastric acids back up into the esophagus. Left untreated, GERD can narrow the esophagus and cause precancerous cell changes.

"Medications help some patients cope with their discomfort," says Khashayar Vaziri, MD, Assistant Professor of Surgery. "Surgery may be an option for those who don't improve with medications or don't want to take medication for the rest of their lives." Dr. Vaziri completed a minimally invasive fellowship program at Northwestern University.

For those patients with GERD, a minimally invasive Nissen fundoplication procedure may ease their symptoms. During this procedure, the upper portion of the stomach is wrapped around the lower portion of the esophagus to create a new valve and help prevent reflux. Hiatal hernias -- which often contribute to GERD -- can be repaired during the same procedure.

"This surgery can change patients' lives," Dr. Vaziri says. "Patients feel better and can stop taking heartburn medications right after surgery."

Photo of Fred Brody, MD, FACS, MBA
Fred Brody, MD, FACS, MBA, Director of Minimally Invasive Surgery and Associate Professor of Surgery
Tackling Adrenal Gland and Spleen Tumors
Surgeons at the Minimally Invasive Surgery Center use laparoscopic techniques to treat most conditions in the abdominal area, including the adrenal glands and spleen.

"Laparoscopic adrenal and spleen surgeries have a very long track record for success," says Fred Brody, MD, FACS, MBA, Director of Minimally Invasive Surgery and Associate Professor of Surgery.

The adrenal glands, located on top of the kidneys, secrete hormones that help the body cope with stress. The spleen, located on the left side of the body below the rib cage, helps filter the blood. Active tumors in the adrenal glands can lead to the production of hormones that cause high blood pressure, while active tumors of the spleen can affect blood clotting.

To remove these tumors, doctors make three small incisions in the abdomen, inflate the abdomen with carbon dioxide gas and use specially designed instruments to remove the tumors and the adrenal glands or spleen.

"Minimally invasive techniques are especially helpful when operating on structures deep in the abdomen, such as the adrenal glands, because they help patients avoid large incisions and longer, more painful recoveries," Dr. Brody says.

Photo of Vincent Obias, MD, MS
Vincent Obias, MD, MS, Assistant Professor of Surgery
Specialized Surgery for Colorectal Cancer
Colorectal (colon or rectum) cancer is the second leading cause of cancer deaths in the United States. Affecting both men and women, it becomes more common as people age.

Surgeons at GW Hospital offer minimally invasive laparoscopic surgery to remove the diseased sections of the colon through the abdomen.

"The visualization is so good that nerve injury can be minimized, and the incisions are so small, patients go home sooner with less pain," says Vincent Obias, MD, MS, Assistant Professor of Surgery. Dr. Obias completed a colon and rectal fellowship at the Cleveland Clinic Foundation and an advanced laparoscopy colon and rectal fellowship at University Hospitals Case Medical Center.

Certain patients may be candidates for transanal endoscopic microsurgery, an advanced procedure available at few hospitals. Surgeons insert a scope into the anus to view and remove polyps or cancerous tissue without incisions.

"Rectal surgery is very complex," Dr. Obias says. "It's important for patients to seek care from a surgeon who has specialized training in this area." In addition to cancer treatment, GW Hospital also offers innovative procedures to treat Crohn's disease, ulcerative colitis, polyp disease, diverticulitis and rectal prolapse.

Photo of Paul Lin, MD
Paul Lin, MD, Chief of the Division of General Surgery and Associate Professor of Surgery
Organ-Preserving Surgery for Liver and Pancreatic Cancers
Advanced diagnostics like computed tomography (CT) scans are so sensitive that doctors are identifying asymptomatic liver and pancreatic tumors earlier, allowing for potentially lifesaving and organ-preserving treatment.

Liver cancer may begin in the liver or spread to there from other organs. A patient with liver cancer may have no symptoms or may have pain in the right side of the abdomen and yellowing of the skin.

Pancreatic cancer may develop in the organ that produces insulin and digestive enzymes. Symptoms may include yellowing of the skin and eyes, pain in the abdomen and back, weight loss and fatigue.

Both cancers typically are treated with chemotherapy and radiation therapy. However, surgery may be an option when the cancers are found early and have not spread to other structures in the body.

"We try to save as much of the organ as we can," says Paul Lin, MD, Chief of the Division of General Surgery and Associate Professor of Surgery. "We have advanced tools -- including better visualization, coagulation and stapler devices -- that allow us to laparoscopically remove the portion of the liver or pancreas that contains the tumor and leave the rest of the organ intact."

One technique, thermal ablation therapy, allows doctors to treat small tumors deep in the liver. A probe is placed in the tumor that delivers radiofrequency energy that heats and destroys the diseased tissue while preserving more of the liver.

Is Laparoscopic Right for You?
Ask your doctor if minimally invasive surgery is an option for you. To find out more about the services available at the new Minimally Invasive Surgery Center, please call 1-888-4GW-DOCS.

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The George Washington University Hospital Health News