Entries in surgery (83)


Best, Worst Hospitals for Weight-Loss Surgery

Jupiterimages/Thinkstock(WASHINGTON) -- Hospitals that perform at least 375 weight loss operations a year have the best safety record for bariatric surgeries, while those that performed fewer than 75 a year had the highest rate of complications, according to a new study by a hospital rating group.

The complications from bariatric surgeries could include internal bleeding, a collapsed lung, and even death.

The study by HealthGrades, an independent health care ratings company, found 100 hospitals in the 19 states it surveyed that it rated as one star, or "poor performers," for weight loss operations.

Another 107 hospitals were rated five-star by the group, and 261 hospitals earned three stars. A total of 468 hospitals were studied and the survey reviewed 190,000 bariatric surgery patients treated between 2007 and 2009.

"When you're having a major procedure, a lot of times you choose a facility through word-of-mouth," said Kristin Reed, vice president of hospital rankings for HealthGrades. "But this report gives people objective information to make decisions based on real outcomes."

"We hope that hospitals use this information to compare their performance results" to those from five-star facilities and look for ways to "tighten up their practices," Reed said.

At facilities given a five-star rating, like Providence Saint Joseph Medical Center in Los Angeles or Saint Luke's Roosevelt Hospital in New York City, patients were nearly 70 percent less likely to experience complications.

Other five-star-rated hospitals, as rated by HealthGrades, include California Pacific Medical Center in San Francisco, Lowell General Hospital in Boston, Albert Einstein Medical Center in Philadelphia, and Bayshore Medical Center in Houston.

Patients who went to the top ranked hospitals had shorter hospital stays and a smaller bill, saving on average $6,692 compared to patients who checked into a "1-star" hospital like University of California, Irvine, or Staten Island University.

Other 1-star-rated hospitals include Mount Sinai Hospital in New York City, Temple Community Hospital in Los Angeles, Massachusetts General Hospital in Boston, and Baylor University Medical Center in Dallas.

Copyright 2011 ABC News Radio


Prostate Surgery May Not Necessarily Mean End of Sex Life

Jupiterimages/Thinkstock(LONDON) -- Health experts say undergoing prostate surgery does not necessarily mean the end of a man’s sex life.

Experts at The Prostate Centre in London say the majority of men that are treated at the center are able to continue with their sex lives after undergoing surgery, with experts adding that psycho-sexual counseling may contribute positively to men’s sex lives getting back on track following surgery.

“On average, 8 out of 10 men I see who have had prostate surgery continue having sex lives afterwards,” Lorraine Grover, the Centre's expert in psycho-sexual counseling said in a statement. “Psycho-sexual counseling, in addition to a wide range of medications and devices, plays a key role in helping men address these sorts of fears. That's why men shouldn't ignore prostate problems, but get themselves checked out.”

The Prostate Centre says psycho-sexual counseling can help men with reintroducing intimacy into their relationship after surgery; recognizing and overcoming fears over sexual performance; and making sense of their sex lives and the role it plays in their relationship.

Copyright 2011 ABC News Radio


Giffords’ Prognosis Good, but Continued Recovery Won't Come Easy

P.K. Weis/Giffords Campaign - P.K. Weis via Getty Images(HOUSTON) -- Although Rep. Gabrielle Giffords has come far enough in her recovery to leave the rehabilitation center where she spent the past five months, doctors agree she is only at the beginning stages of her rehabilitation.

She will start outpatient therapy soon, which is likely to include speech, occupational, and physical therapy a few days a week. Experts believe her continued rehabilitation will take a long time as she attempts to recover many of the skills and abilities she lost after being shot in the head in January.

"The time frame for outpatient therapy is long, with her program continuing to be adjusted as she improves. Years of treatment is not unusual," said Dr. Brian Greenwald, assistant professor of rehabilitation medicine at The Mount Sinai Medical Center in New York. "Despite the fact that the most rapid recovery occurs in the first year, recovery continues for a long time to come."

"You need to consider rehabilitation as a parallel process to normal child development," said Dr. Gregory O'Shanick, president and medical director of the Center for Neurorehabilitatoin Services in Richmond, Va. "Children learn to control their motor and balance systems at an earlier stage than they are able to speak, read or conceptualize. Giffords' rehab has gotten her back to walking and indicating her needs in a fundamental level."

The most critical issue, he said, is to get her to the point where she can solve problems and reason the way adults do. Giffords also has to continue working toward regaining her ability to function as she did before she was shot.

"Recovery can be in the form of regaining the ability to do things in the same way that she did before as well as adapting to or compensating for persistent deficits," said Dr. Thomas Watanabe, clinical director of the Drucker Brain Injury Center in Elkins Park, Pa.

Giffords may actually do better now that she's able to go home.

"The literature shows that people often do better with cognitive outpatient therapy after reaching a certain level than with inpatient. This is because they are in more familiar surroundings and are ready for the challenges of being home," said Dr. Steve Williams, chairman of the Department of Rehabilitation Medicine at Boston University School of Medicine.

Despite the progress she has already made, the Arizona congresswoman may never recover some functions.

"Rep. Giffords may never fully recover the prior fluency of her communication abilities, but there can continue to be improvement with therapy," said Dr. Lori Shutter, associate professor of clinical neurosurgery and neurology at the University of Cincinnati Medical Center.

While she may recover physically, she also has to overcome psychological damage.

"The psychological recovery will likely take even longer," said Dr. Charles Liu, director of neurosurgery at Rancho Los Amigos National Rehabilitation Center in Downey, Calif. "The psychological recovery will obviously be impacted by her evolving role as a high-profile victim of gunshot wound to the head.

Giffords had the advantage of remaining at an inpatient rehabilitation center for five months, much longer than others who don't have the same insurance coverage or financial resources.

"As a rehabilitation physician, I always want the patient to stay as long as possible as long as medical gains and improvements are being made," said Dr. Michael Huou, assistant professor of clinical neurology and neurological surgery at the University of Southern California's Keck School of Medicine in Los Angeles. "Unfortunately, the length of stay is generally dictated by the insurance company which typically wants the patient to be discharged home or to a [nursing home] in a much quicker time frame."

Most insurance companies also only pay for about a month of outpatient rehabilitation, but doctors believe Giffords will likely get much more than that.

No one can be sure how far she will progress, and she'll be working to recover for the rest of her life.

"Brain injury rehab is a lifelong process, and she'll need to work on it every single day," said Dr. Brent Masel, national medical director of the Brain Injury Association of America.

Copyright 2011 ABC News Radio


Texas Man Pioneers Use of Beatless Heart

Drs. Billy Cohn and Dr. O.A. "Bud" Frazier have developed a heart that does not beat. (Courtesy of the Texas Heart Institute)(HOUSTON) -- Craig Lewis, a 55-year-old Texas man who was about 12 hours away from death, became the first human to receive what doctors are calling the "beatless heart."

The device -- two ventricular assist devices intricately tied together, replacing his entire heart -- was developed by Drs. Billy Cohn and O.A. "Bud" Frazier at the Texas Heart Institute in Houston.

They say this new machine, which whirls instead of pulses, is more reliable and could replace existing artificial hearts, which wear out and can cause clotting and strokes.

"Every animal created has a pulsatile heart, and to mimic that was the natural way to proceed," said Cohn. "But to make something that actually can beat 100,000 times a day, 35 million times a year, a man-made device has to perform with that kind of endurance."

"A car can, but you change the oil and the spark plugs and do the maintenance and they go and go," he said. "These pulsating hearts work only a year or two, then fall apart."

Older devices would have also been too large to place in women's smaller bodies. The new beatless heart is "self-contained, smaller and a more durable device," said Cohn.

Lewis, in the advanced stages of cardiac amyloidosis, which causes the organs to fail as the body accumulates abnormal proteins, had been in a coma-like state. He died last March from underlying disease, five weeks after receiving the beatless heart.

But doctors said that the heart worked perfectly. Lewis was able to sit up and talk to his family before his kidneys and liver eroded. The family ultimately chose to turn off the heart device to allow him to die "humanely," said Cohn.

The first "beatless" heart experiments were done on a calf named Abigail, and later on 38 calves, whose hearts were removed and replaced with two centrifugal pumps.

In March, when doctors felt confident the artificial heart would also work in humans, they were approached by Craig Lewis' wife, Linda.

Hospital officials said she was "too emotional" to talk to ABC News, but in another interview earlier this week, she said that her husband would have appreciated the doctors' invention, fashioned from Dacron, fiberglass and silicone.

Until now, those with full heart failure have had only had two options: a first-generation artificial heart that had limitations, or a heart transplant. But the wait for a new heart can be long, if one becomes available at all. More than 100,000 Americans are on a list for about 2,200 hearts a year.

The new machine relies on two simple whirling rotors, spinning blood throughout the body in a continuous flow, addressing previous problems with clotting, thrombosis and bleeding.

"I think it's fascinating," said Dr. Jay Pal, assistant professor of cardiothoracic surgery at the University of Texas Health Science Center in San Antonio.

Left ventricular assist devices, like the one that keeps former Vice President Dick Cheney alive, only help those with failure of the left side of the heart. This device can help those with right-side failure or failure on both sides.

Lewis had not been a candidate for an assist pump because his left ventricle was too badly damaged by disease, and his right ventricle had also failed.

"It certainly provides more options for people who are living with advanced heart failure, and results like these show a lot of promise and move the field forward," said Pal.

Copyright 2011 ABC News Radio


Hypnosis to Replace Anesthesia During Surgery?

Jupiterimages/Thinkstock(BRUSSELS, Belgium) -- Partial mastectomy, biopsy and removal of lymph nodes, removal of the thyroid -- would you be willing to undergo these surgical procedures without general anesthesia? One Belgium hospital reportedly performs a third of their thyroid surgeries and a quarter of all breast cancer surgeries with only local anesthetic and hypnosis.

A study conducted by the Saint-Luc University Hospital has found that women who underwent the removal of their thyroids using only local anesthesia and hypnosis had lower use of opioids pain killers, shorter hospital stay, and greater satisfaction compared to women who opted for general anesthesia.

The findings were presented at a European Anaesthesiology Congress meeting, and researchers say the approach may be broadened to other surgeries including hernias, gynecological surgeries, plastic surgery procedures, and even some heart surgeries, thereby also providing benefits for healthcare systems by reducing costs involved in longer hospital stays.

Copyright 2011 ABC News Radio


Should Lap Band Be Approved for Teens?

Creatas/Thinkstock(WASHINGTON) -- More teenagers may now have the opportunity to turn their weight around through Lap-Band procedures -- possibly even with FDA approval. Currently, minors must have parent permission, but the Lap-Band creator, Allergan, has requested that the FDA approve Lap-Band procedures for anyone more than 14 years old. The procedure uses a temporary elastic band to consrict the patient's stomach so that it can only hold a small amount of food.

Cathy Taylor, a spokesperson for Allergan, said the company made the request because of the increase in obese teenagers, and the disease's correlation to life-threatening conditions such as heart disease and type 2 diabetes.

"In addition, the prevalence of obesity continues to rise, making it a significant health epidemic," said Taylor. "Due to all of the above, Allergan continues to be committed to the research and development of the Lap-Band System to help those affected by obesity, to improve their health and lives."

Because the Lap-Band System is not currently FDA-approved for use in patients younger than 18, Taylor said, "Allergan does not promote the use of the product with adolescents. Therefore, we cannot elaborate on the potential benefit of Lap-Band in this patient population."

But that does not mean the company is not trying to prove that it is beneficial to adolescents. Amanda Sena, a spokesperson for the FDA, confirmed that Allergan is currently conducting clinical trials in the United States to determine the effectiveness of the Lap-Band in the morbidly obese teen population.

Sena said she could not comment on when the FDA would come to a decision for Lap-Band use in teens.

The Lap-Band procedure in teens remains a controversial issue. While some obesity experts agree that the surgery should be available for teens, others believe the procedure should be a last resort, if not forbidden altogether, in this age group.

Copyright 2011 ABC News Radio


Botched Surgery: Rare Disfiguring Result Brings Record Award 

Pixland/Thinkstock(LONDON) -- A self-made British businesswoman who testified that nerve damage from a facelift ruined her consulting business and family life has won a record $10 million judgment from a British judge.

Penny Johnson, 49, said she consulted Dr. Le Roux Fourie, a cosmetic surgeon in Leeds, UK, about eliminating dark circles under her eyes and reshaping her nose, but the doctor talked her into more extensive procedures. After undergoing a facelift and replacement of her breast implants, she developed palsy on the right side of her face. Despite some improvement following surgical revisions, Johnson developed uncontrollable right-side twitching, a grimace, and couldn't close her right eye. In 2007, she sued Fourie.

Unable to work, she initially sued Fourie for the value of her 50 percent share in Bishop Cavanagh Ltd., a consulting firm she and her husband ran. Fourie admitted negligence in her case, but his attorneys claimed Johnson was seeking excessive compensation -- $87 million.

"The negligent surgery has had serious consequences both physical and psychological," Justice Owen wrote in the judgment he issued this week. "The physical injuries have resulted in a prolonged adjustment disorder with features of anxiety and depression."

He described Johnson, of Godstone in Surrey, as "a confident, happy and outstandingly successful woman with a full and rewarding family and social life" before her ordeal.

In rejecting her accounting of lost future earnings, Justice Owen reduced her economic losses to slightly more than $10 million.

Copyright 2011 ABC News Radio


Bone Doc, 74, Keeps Patients Working Longer

Courtesy of Jefferson University(PHILADELPHIA) -- When his alarm clock rings at 5 a.m., Dr. Richard Rothman can't wait to get up and go to work. In a typical week, the Philadelphia-based orthopedic surgeon replaces about 20 hips and knees. The procedure allows people with arthritis to keep leading productive lives into old age -- an opportunity that Rothman, 74, considers a privilege.

"I love going to work. And I really believe people should keep working as long as they can," Rothman said. "It's good for you!"

Arthritis is the most common cause of disability among adults in the United States, limiting the lives of nearly 21 million people, according to the U.S. Centers for Disease Control and Prevention.

"If you can't stand or walk, it's very hard to earn a living, keep a family together and enjoy life," Rothman said. "Right at the center of economic and physical well being is that your joints have to work. You wear out [a] hip or knee, and it really limits your ability to stay productive and healthy."

Since performing one of the nation's first total hip replacements 42 years ago, Rothman has replaced more than 25,000 hips and knees. The physically taxing procedure, which swaps the boney joint for a prosthetic usually made of titanium and hard plastic, revolutionized the treatment of arthritis.

Joint replacement surgery is on the rise and is expected to keep rising as the population ages. Between 1996 and 2006, the number of total hip and knee replacements increased by 30 percent and 70 percent respectively, according to a CDC report.

With the generous gift of a philanthropic patient pleased with his new hips, Rothman founded and built the Rothman Institute in Philadelphia -- an orthopedic center that employs 80 top surgeons performing 18,000 operations a year. The institute, Rothman said, is a dream come true.

Copyright 2011 ABC News Radio


Giffords' Brain Surgery Safe, but Not Risk-Free

Tom Williams/Roll Call/Getty Images(HOUSTON) -- The operation to replace a piece of Rep. Gabrielle Giffords' skull was an important and necessary step in her recovery, neurosurgeons told ABC News on Wednesday. But the surgery was not without risks, doctors say.

Doctors at Memorial Hospital in Houston performed the surgery Wednesday morning, more than four months after the shooting in Tucson, Ariz., that left six dead and 13, including Giffords, injured. The injury Giffords sustained when she was shot in the head led to brain swelling -- an emergency that necessitated the removal of a portion of her skull to relieve pressure.

For some patients, the operation simply replaces the part of the skull that was removed; in Giffords' case, the surgical team, led by Dr. Dong Kim, inserted a plastic replacement that had been custom-designed to fill the space in her skull.

Dr. Charles Liu, chief of neurosurgery at Rancho Los Amigos at the University of Southern California Medical, said complications from the procedure are rare, but they do happen.

"The operation is pretty straightforward, but there are potentially serious risks," Liu said. "These include the formation of a large blood clot beneath the implant -- epidural hematoma -- as well as infection."

Other doctors not involved in Giffords' case agreed that although the operation can come with some minor risks, it is usually a safe one.

"While this is still considered brain surgery, there are much less risks than the initial operation," said Dr. Ricky Madhok, a neurosurgeon at the Cushing Neuroscience Institutes of the North Shore Long Island Jewish Health System in New York. "We still worry about bleeding, strokes, seizures and infections, but the risk is much lower, as we are recreating the contour and the protection offered by the skull and not actually manipulating the brain itself."

Copyright 2011 ABC News Radio


Innovative Surgery Helps a Young Girl Take Back Her Smile

Jupiterimages/Thinkstock(BOSTON) -- Caitlin Cowen, 19, of Phibodeaux, La., laughed as she talked about majoring in mass communications. Her laugh signaled so much about her enthusiasm, especially since two years ago, Cowen couldn't even smile.

"A smile was a simple form of communication," said Cowen, a sophomore at Louisiana's Nicholls State University. "I felt like if I was happy, I couldn't show it. So it meant that I wasn't really happy."

In 2008, Cowen suffered partial paralysis after undergoing surgery to remove a tumor from the right side of her brain stem. Cowen was bound to a wheelchair for months as she worked to regain strength and overcome paralysis on the left side of her body, paralysis that made it impossible for Cowen to move the muscles that would allow her to smile.

But a year later, Cowen underwent an innovative surgery at the Massachusetts Eye and Ear Infirmary in Boston -- called free gracilis transfer -- to restore muscle movement to her face.

In two procedures, surgeons took nerve and muscle tissue from Cowen's thigh and implanted it into the paralyzed side of her face.

While surgeons have used free gracilis transfer for more than a decade, it was considered arduous and could take up to 12 hours, according to Dr. Mack Cheney, a professor of facial reconstructive surgery at Harvard Medical School, and one of Cowen's doctors.

But free gracilis transfer has advanced so dramatically in the past five years that it should be considered first-line therapy for children who have facial paralysis, according to a paper released Monday in the Archives of Facial Plastic Surgery, which Cheney co-wrote.

Free gracilis transfer works for patients who are born with facial paralysis, as well as for those who have endured brain tumors or other traumas that have caused paralysis, said Cheney, who oversees about four of these procedures each month.

Cheney said that facial paralysis is emotionally hardest for patients like Cowen, who once had normal facial function.

"The ability to communicate and understand emotional signals go away, which is different from patients who never had that facial function to begin with," he said. "When you lose it, you feel the difference."

But a few months after Cowen's second surgery, nearly two years after the brain stem surgery that left her partially paralyzed, Cowen could smile again.

In March, Cowen was crowned queen of her sorority's mardi gras dance. And in each of her photos, she was all smiles.

"Every time I see myself smile, I think it's awesome," said Cowen. "I think I appreciate it more."

Copyright 2011 ABC News Radio

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