|
Simply put, Surgeons that have
accumulated a certain amount of points qualified for the list. This does not
mean that Surgeons that did not accumulate enough points are not good Surgeons.
They merely did not qualify for this list because of the points needed for
qualification.
Similar studies have been done with
other professions using a survey system. This type of study would ask fellow
professionals on who they would recommend. We found this method to be more of a
popularity contest, for instance; professionals who work in a large office have
much more of a chance of being mentioned as opposed to a professional who has a
small private practice. In addition many professionals have a financial
arrangement for back-and-forth referrals. For these reasons, we developed the
point value system.
Since this is a subjective call,
there is no study that is 100% accurate. As with any profession, there will be
some degree of variance in opinion. If you survey 100 patients from a particular
physician on their satisfaction, you will undoubtedly hear that some are very
satisfied, some moderately satisfied and some dissatisfied. This is really quite
normal.
We feel that a point value system
takes out the personal and emotional factor and deals with factual criteria. We
have made certain assumptions. For example, we feel that the more years in
practice is better than less years in practice; more education is better than
less education, etc.
The top Surgeon list that we
have compiled is current as of a certain date and other Surgeons may have
qualified since that date. Nonetheless, we feel that the list of top Surgeons is
a good starting point for you to find a qualified Surgeon.
No fees, donations, sponsorships or advertising are accepted from any
individuals, professionals, corporations or associations. This policy is
strictly adhered to insure an unbiased selection.
Finding a
Surgeon
Choosing a Surgeon is an important
decision. The Surgeon you are looking for should be qualified at performing the
procedure you need as well as understanding the particular circumstances of your
case. The Surgeon should provide you with realistic information about the
procedure and the outcome of your results. We strongly recommend finding a
Surgeon that is board certified and who has received surgical instruction,
training and experience in the procedure you need. Thus, our goal is to assist
you in making that decision. First of all, when selecting a
Surgeon, you may want to begin your search several different ways:
| Ask
a family physician. He or she is in constant contact with all kinds of
healthcare professionals and will be able to point you in the right
direction. |
| Ask
family, friends, neighbors and/or co-workers. |
| Contact
your local hospital and speak to surgical ICU nurses that do a lot of
the procedures you are having done. These nurses take care of the end
results of all Surgeons. |
| Contact
your city, county or state medical agencies for names of qualified
Surgeons. Contact and ask for referrals from medical associations. Many
are listed in this book. |
Surgical
Specialties
|
Each surgical specialty has its own
accrediting board for training and educating Surgeons for their
specialty. Some of the boards have a sub-specialty which require
additional training and examinations. Some examples of these
sub-specialties are Hand
Surgery, Pediatric
Surgery and Vascular Surgery.
 A Surgeon first obtains a medical license. The Surgeon is
required to take a program that is accepted by the Residency Review
Committee for the specialty they are wanting to obtain. When the training
is completed, the appropriate medical specialty board administers an
examination for certification. The Surgeon is then required to make use
of the facilities at a given hospital,
which has various
committees that review all surgical cases. The hospital is reviewed by
the Joint Commission on the Accreditation of Hospitals to make sure
policies are being adhered to and that patient care is being handled at
a high standard.
General
Surgery
General Surgery is the largest of all the surgical
fields. This area of expertise includes abdominal organs, the breast,
thyroid, parathyroid, pancreas, digestive tract, blood vessels and injury
management. There are two sub-specialties in general surgery that require
additional training and examinations. These include pediatric surgery and
hand surgery.
Colon &
Rectal Surgery
Practitioners of this field are trained to diagnose
and treat patients who have disorders of the colon, anal canal, rectum,
and perianal area. These Surgeons have expertise in dealing with medical
problems such as hemorrhoids, fissures, lower digestive tract issues,
inflammatory diseases, polyps and cancer.
Thoracic
Surgery
Thoracic Surgeons devote themselves to the
operative conditions within the chest. Areas of specialization include the
chest wall, the lungs, the heart, esophagus and major blood vessels in the
chest area. Many Thoracic
Surgeons specialize in cardiac procedures such as heart transplants,
implantations of cardiac pacemakers, replacement of diseased and damages
heart valves, bypass operations of the coronary arteries and surgical
corrections and treatment of congenital heart defects. A Thoracic Surgeon
has substantial knowledge and skills in cardiorespiratory physiology. The
Surgeon is part of a large team of highly trained professionals that
include cardiologists, heart-lung pump teams, catheterization teams,
radiologists performing angiographies, echocardiography teams and nursing
teams.
Vascular Surgery
This is an area of surgery that specializes in the disorders
and treatment of blood vessels which affects all areas of the body with
the exclusion of heart and intercranial vessels. A vascular Surgeon uses a
variety of diagnostic techniques observing internal structures, including
endoscopy and using specialized medical equipment.
Plastic Surgery
A Plastic Surgeon deals with the repair and
restoration to the skin and underlying areas when injuries come about from
accidents and major surgical operations. Reconstructive procedures include
modifying tissues and scars to minimize or eliminate deformities due to
prior operations, birth defects automobile accidents and other traumatic
injuries. It is common for many plastic surgeons to devote their time to
cosmetic surgery procedures. Typical cosmetic surgery procedures include
Rhinoplasty (cosmetic surgery on the nose), Blepharoplasty (cosmetic
surgery on the eyelids), Face Lift (cosmetic surgery to tighten facial
tissue) and other cosmetic procedures that reducing and enlarging the
breasts.
Neurological
Surgery
A Neurological Surgeon deals with disorders of the
brain, spinal cord, meninges, pituitary gland and nerves throughout the
body. The advanced technology with CAT Scans assists the Neurological
Surgeon in diagnoses and treatment of brain disorders and head injuries.
Orthopedic Surgery
The Orthopedic Surgeon is involved with problems related to joints, bones,
and musculoskeletal oncology. Orthopedic Surgeons do surgical procedures
for replacement of hips and knee joints that are replaced with special
plastic and metals parts as well as the repairing of fractured bones with
pins, plates and screws. They are also concerned with deformities,
injuries and degenerative diseases of the elbows, hips, shoulders, hands,
feet and spine.
Ophthalmic Surgery
Ophthalmic Surgery involves surgical procedures to
the eye. It is common the Ophthalmic Surgeons use micro surgical
techniques performed under a microscope and extensive use of the laser.
This type of surgery includes the removal of cataracts, implantation of
artificial lens, the reattachment of a detached retina, LASIK and many
other vision related procedures.
Otolaryngologic Surgery
This surgical specialty diagnoses and treats diseases
of the ear, nose, throat and larynx. This Surgeon provides surgical
therapy for the prevention of diseases, allergies, deformities and
injuries to the nose, ear and throat, face and jaw. Areas of expertise
include head and neck oncology, facial plastic and reconstructive surgery
and the diagnosis and treatment of hearing and voice disorders. 
Hand Surgery
A Hand Surgeon is specially trained to diagnose and
treat hand related problems. Common problems they treat include carpal
tunnel syndrome, tennis elbow, reattach fingers and treat injured hands.
Pediatric Surgery
The Pediatric Surgeon understands and is
trained to handle surgical procedures on children. Children and infants'
organ systems are not fully developed and procedures, anesthetics,
medications and treatments need to be adjusted accordingly. Many pediatric
procedures include the correction of birth defects and the removal of
potentially cancerous growths.
|
Common
Surgical Procedures
|
Thyroid Surgery
Thyroid experts advise that people over the age of thirty five be
thyroid tested. Experts have concluded that women are seven times more likely than men
to develop a thyroid problem. Age is also another major factor; women at
the age of sixty have a one-in-five chance of having a thyroid problem.
The post-partum and menopausal periods are times when a woman is most
vulnerable to thyroid disorders.
Many symptoms of a thyroid disorder
are common symptoms of other health conditions. These symptoms do not
mean that you have a thyroid disorder, but you should be aware of them
so you can determine if you should be tested by your physician. |
Some common symptoms include:
| |
 |
A high
or low pulse rate |
|
|
Fatigue and exhaustion |
|
|
Anxiety-Panic Attack |
|
|
Low
sex drive |
|
|
High or low blood pressure |
|
|
Insomnia |
|
|
Heart palpitations |
|
|
Mood
swings, irritability |
|
|
Rapid weight gain or loss
despite exercise and diet |
|
|
Irregular
menstrual cycles |
There are various reasons for thyroid
surgery. Common reasons for thyroid surgery include:
| When a woman is pregnant and her
hyperthyroidism can not be controlled and regulated by any other
means. |
| When breathing and swallowing is
difficult due to enlarged thyroid nodules. |
| When cancerous cells have been
discovered near or on the thyroid gland. |
In most cases thyroid surgery is not
complicated and the actual surgery takes less than two hours. It is now common
for this type of surgery to be performed on an outpatient or overnight basis.
There are three types of thyroid surgery performed. They are as follows:
| Thyroid Lobectomy: |
The removal of approximately
one quarter of the thyroid gland |
| Subtotal Thyroidectomy: |
The removal of approximately
one half of the thyroid gland |
| Total Thyroidectomy: |
The complete removal of the
thyroid gland |
|
Most thyroid patients resume work within
seven to fourteen days following surgery. Generally, the only major
restriction will be no swimming. You will be encouraged to move about as
soon as possible. Eating and drinking can be a discomfort and a soft
diet is usually prescribed until it has had time to heal.
Thyroid replacement drugs will almost
always be prescribed for the remainder of the patient's life. It is
common to be tested a month after starting hormone replacement drugs to
make sure that you are not taking too much or too little. A patient
following this surgery should carefully watch for signs of
hypothyroidism which symptoms include fatigue, feeling run down,
depressed, muscle cramps and weight gain. Good patient/doctor
communication and patient follow-up is essential for a good and complete
recovery. |
|
Angioplasty
Angioplasty is a procedure performed
during a heart catheterization. The atherosclerotic blockages in the
coronary arteries are compressed against the vessel wall by expanding a
balloon from within the artery. The angioplasty procedure is an invasive method of opening
blocked arteries that are restricting and impeding blood flow. When the
balloon is inflated, the plaque blocking the interior arterial wall is
compressed and remains compressed, clearing space so the blood flow
volume can increase.
The angioplasty method is a less
invasive procedure as compared to a bypass surgery. Angioplasty has less
risk and the recovery period is much quicker. Your cardiologist will
tell you if you are a good candidate for this procedure. The
cardiologist will take into consideration your age, severity of the
blockage and your overall physical condition.
Angioplasty procedures have been
performed for the past 25 years. Results show that patients are doing
better today because of advanced drug therapies and new advanced
techniques that are better able to detect the exact locations of the
blockages.
In the early 1990's
Surgeons started using stents. Stents are tiny wire mesh tubes which are
inserted permanently at the location of the blockage. The use of stents
have been highly successful in reducing the possibility of arterial
collapse and the renarrowing of the artery which is called restenosis.
Seasoned doctors who perform this procedure are able to install stents
in one or more arteries with a high degree of success.
|
|
Coronary Artery Bypass Graft Surgery
Coronary bypass surgery is very successful in relieving
angina. This surgical procedure is highly invasive which requires the
opening of the chest, routing the blood through a heart lung machine,
transplanting new vessels and stopping and restarting the heart. Bypass
surgery requires taking large blood vessels from the patients legs,
stomach or chest and grafting them to the front and back of the blocked
arteries.
During a bypass procedure the heart-lung machine takes
over the functions of the heart and  lungs. This is done so the heart can be carefully
stopped and the Surgeon can work in a blood-free environment. The
heart-lung machine keeps oxygen-rich blood flowing through the body. It
receives the blood and removes the carbon dioxide and other waste
products, warms and/or cools the blood and adds oxygen as it pumps the
blood through the patient's body. At the conclusion of the bypass
surgery, the heart is restarted and the heart-lung machine is
disconnected.
New advances in bypass surgery are continuing. A
minimally invasive bypass surgery technique is being tested with
promising results. This new procedure requires the Surgeon to work on
the front of the heart through a four inch incision while it is beating
slowly. Another type is that the heart is stopped and a Surgeon uses a
fiberoptic scope that is passed through a 4 ½ inch incision and the
Surgeon works on all sides of the heart by viewing a video image. This
less invasive procedure would be less expensive and requires a much
shorter hospital stay.
|
|
Rhinoplasty
Rhinoplasty is plastic surgery of the
nose. This procedure is very common and you are a good candidate for
this procedure if:
| |
|
Your
nose is
crooked or off-center |
| |
Nostrils are excessively wide or flared |
| |
A bump or high
point on your nasal bridge |
| |
Your
nose is too large for your face |
| |
The
nasal tip is sagging or thickened/ enlarged |
Many Surgeons prefer not to operate on
teenagers until they have completely stopped growing. Each case is individual and
needs to be discussed in detail with your Surgeon.
The actual procedure usually takes
between one and two hours. Rhinoplasty can be performed under local or
general anesthesia depending on what procedure you and your Surgeon have
decided upon. The skin of the nose is separated from the bone and
cartilage and then is sculpted to the desire shape. Many times the
incisions are made on the inside of the nose, depending on the Surgeon and
what exactly needs to be done.
Your face will experience
discomfort for the first twenty-four to forty-eight hours. It
is common for your face to feel swollen and for you to have a headache after this procedure.
It is usually recommended to stay off of your feet for the first 24 hours and
get proper rest. By applying cold compresses, swelling and aching will
be reduced to a minimum. Slight bleeding will occur and blowing your
nose is not advisable for the first
week following the procedure. |
|
Arthroscopic Surgery
Until recently, treatment, diagnosis and examinations were difficult in
orthopedic injuries. The arthroscope has made it possible for Surgeons
to treat joint injuries quickly and effectively. The arthroscope is a
small fiber optic medical device used for viewing. This high-tech
instrument consists of a tiny lens and video with a light source.
The arthroscope is inserted through a
very tiny 1/4" incision into the joint. The incision is called a
portal. Other portals in the immediate area are used for the insertion
of other medical instruments used in the surgical procedure. An
arthroscopic Surgeon can correct and diagnose a variety of problems such
as ligament tears, arthritis and other joint-related problems. The
portals leave very little scars and many times are unnoticeable. |
|
Gallbladder Surgery
Each year over 500,000 Americans have gallbladder surgery. One type of
gallbladder surgery is called a laproscopic cholecystectomy. It is used
in 95% of gallbladder removal surgeries. The Surgeon inserts a miniature
video camera and surgical instruments through tiny incisions in the
abdomen. The video camera transmits images to a video monitor, giving
the Surgeons a close up and detailed view of the various organs and
tissue. While using the camera as his eyes, the Surgeon separates the
gallbladder from the liver, ducts and other tissue. The cystic duct is
cut and the gallbladder is removed through one of the small incisions.
Laparoscopic surgery is preferred since abdominal muscles
are not cut. This results in a much quicker recovery and sometimes
requires only one night in the hospital. However, an open surgery is
sometimes required due to complications. They call this an open surgery
because it requires an incision that is 5 to 9 inches long in the
abdomen. This is considered a major surgery with up to a one-week stay
at a medical facility. |
|
Vasectomy
A vasectomy is a simple surgical
procedure that causes sterility. Over 500,000 men in America choose to
have this procedure done as a permanent form of birth control. Vasectomy
is nearly 100% effective.
A vasectomy makes
men sterile by keeping the sperm out of the fluid that is discharged
through the penis during sex. The sperm are the male's reproductive
cells; when sperm meet with a woman’s egg, pregnancy results. The
sperm passes through tubes called vas deferens to other glands and mixes
with seminal fluids to make semen. A vasectomy blocks the vas deferens
so the semen does not contain sperm. Without the sperm, a pregnancy can
not occur.
Men consider a vasectomy for the following reasons:
| |
Their mate's health could be in
jeopardy if by a future pregnancy.
They want to enjoy the act of sex without causing a pregnancy.
They do not want a child in the future.
Other methods of birth control are unacceptable.
They do not want to pass on any hereditary illnesses.
It
is easier, safer, faster and more cost effective than to
have
their mate undergo a tubal sterilization. |
This simple surgical procedure takes
about twenty minutes to perform. Your family doctor or local hospital
can assist you in finding a Surgeon to perform this procedure. Most men
will recover with little or no time off of work. Many of these procedures
are scheduled on a Friday and the patient can return to work by the next
Monday morning.
|
|
Vasectomy (No scalpel)
The no scalpel vasectomy was developed in
China over 25 years ago. Since that period over 10 million men have had
no scalpel vasectomies. A small puncture is made in the skin with a
specially designed clamp, then the vas deferens are clipped and divided.
The hole is so small that sutures are not required. There is less
bleeding, discomfort, swelling and chance of other complications. Using
the no scalpel technique, the complication rate for a vasectomy
procedure has gone down to 0.4% as compared to 3.1% with the standard
incisional technique. The no scalpel surgery takes about 12 to 15
minutes under local anesthesia and is an office procedure. |
|
LASIK Surgery
LASIK, or "LAser in SItu Keratomileusis"
is the most common refractive surgery
procedure used to correct poor vision. This procedure is great for
people who are tired of wearing glasses or who have a difficult time
wearing contact lenses. Many people who are susceptible to getting eye
infections from contact lenses will opt for this surgery.
The actual procedure is fast and
virtually painless. First, anesthetic eye drops are put in your eye.
After a few moments the eye drops will start numbing the nerves of the
eye. A suction ri ng
is then placed over the center of the cornea. The suction creates
pressure in the eye which is required for the microkeratome to function
properly. The microkeratome is a highly sophisticated instrument that is
of paramount importance in the LASIK procedure. The instrument has an
extremely sharp blade that moves back and forth at a very high speed .
It actually shaves a thin layer of the cornea and folds the cornea back.
The part of the cornea that is uncut acts as a hinge.
At that point the suction ring
and the microkeratome are removed. The next instrument used is the
excimer laser. This laser uses a cool ultraviolet light beam to
precisely remove very minute pieces of tissue from the cornea to
actually reshape it. A properly shaped cornea will focus light into the
eye and onto the retina, resulting in clear vision.
The last step is folding back
the cornea into its original position. Your eyes heal very fast and your
vision will improve immediately.
When opting for this procedure,
finding a physician is very important. Even with the highly technical
and sophisticated excimer laser and microkeratome, the physician is
still the most important part of the procedure. Therefore, choosing a
physician should take a lot of thought and consideration. Many consumers
can be fooled by the clever advertisements they hear on the radio or see
on TV. For instance, it is common for vision correction facilities to
advertise that they have performed over 20,000 procedures. Although this
may be true, it does not mean that the physician performing your
surgeries has done all 20,000 procedures. Therefore, find out how many
surgeries the actual doctor performing your surgery has done. We suggest
that he or she has done a minimum of 300. We also suggest asking your
family physician or friends for any recommendations when searching for
the right Surgeon.
Also, feel free to ask
your physician questions. Most eye-care professionals don’t mind if
you ask them questions.
Here are a
few questions you may consider asking:
|
How many procedures have you performed?
How long have you been performing the LASIK
procedure?
What is your complication rate for LASIK
treatment?
Who will perform my pre-treatment testing?
Who will perform my post-treatment follow up?
|
We also suggest asking your family
physician or friends for any recommendations. |
Gastric Bypass
Surgery
|
Gastric
bypass surgery is a type of procedure that can be used to cause significant
weight loss. Gastric Bypass is
the most common form of weight loss surgery in the United States because it
results in reliable weight loss with acceptable risks. Gastric bypass operations
combine the creation of a small stomach pouch to restrict food intake and
construction of bypasses of the duodenum—the first part of the small
intestines—and other segments of the small intestine to cause
malabsorption—the decreased ability to absorb nutrients from food. The
surgery reduces your body's intake of calories. Calorie reduction is
accomplished in two ways: 1. After the surgery, your stomach is smaller. You
feel full faster and learn to reduce the amount that you eat at any given time.
Simply put, patients cannot eat as much as they did before the surgery. 2. Part
of your stomach and small intestines are literally bypassed so that fewer
calories are absorbed. Sometimes nutrients are lost as well. People who
have bypass operations generally lose two-thirds of their excess weight within 2
years.
In digestion, food passes through the
stomach and enters the small intestine, where most of the nutrients and calories
are absorbed. Food then passes into the large intestine, and the remaining waste
is eventually excreted.
The most common gastric bypass surgery is
a Roux-en-Y gastric bypass. In a Roux-en-Y gastric bypass, the stomach is made
smaller by creating a small pouch at the top of the stomach using surgical
staples or a plastic band. The smaller stomach is connected directly to the
middle portion of the small intestine, bypassing the rest of the stomach and the
upper portion of the small intestine (duodenum).
Extensive gastric bypass
In this more complicated gastric bypass
operation, portions of the stomach are removed. The small pouch that remains is
connected directly to the final segment of the small intestine, so it is
completely bypassing both the duodenum and jejunum. While this procedure
effectively promotes weight loss, it is not widely used because of the high risk
for nutritional deficiencies.
Risks
People who undergo this procedure are at
risk for the following:
1.
Nutritional deficiencies causing health problems.
2.
Leakage of stomach contents into the abdomen. This is dangerous
because
the acid can eat away at other organs.
3.
Your stomach may stretch out to the way it was before surgery
Limited absorption of vitamin B12 and
iron can cause anemia. The lack of calcium absorption can cause osteoporosis and
metabolic bone disease. People who undergo this procedure are instructed to take
nutritional supplements that usually prevent these deficiencies. The more
extensive the bypass operation, the greater is the risk for complications and
nutritional deficiencies
Roux-en-Y
gastric bypass operations may also cause dumping syndrome, an unpleasant
reaction that can occur after a meal high in simple carbohydrates, which contain
sugars that are rapidly absorbed by the body. Stomach contents move too quickly
through the small intestine, causing symptoms such as nausea, bloating,
abdominal pain, weakness, sweating, faintness, and sometimes diarrhea after
eating.
|
Common Knee
Surgeries
|
Anterior
Cruciate Ligament
When you twist your knee or
fall on it, you can tear a stabilizing ligament that connects your
thighbone to the shinbone. The Anterior Cruciate Ligament (ACL) unravels
like a braided rope when it’s torn and does not heal on its own.
Fortunately, reconstruction surgery can help many people recover their
full function after an ACL tear. Anterior cruciate ligament surgery is
usually not performed until several weeks after the injury. Studies have
shown better results when ACL reconstruction surgery is delayed several
weeks from the time of injury. This time allows the inflamed and
irritated knee to settle down—swelling decreases, inflammation
reduces, and range of motion improves. Swelling and stiffness prior to
ACL reconstruction surgery improves the post-operative function of the
joint. The techniques for ACL reconstruction have changed a great deal
in the past 10 years. As a result, ACL knee surgery is now improved and
the rehabilitation is generally easier.
The cruciate ligaments in your
knee joints crisscross to give you stability on your feet. People often
tear the ACL by changing direction rapidly, slowing down from running or
landing from a jump. People involved in sports are especially vulnerable to
damaging their ACL.
Today, a part of a tendon,
usually from somewhere else around your knee, is removed and put in the
place of the torn ACL. The ACL is like a rope that is made from
lots of little individual fibers, and it is impossible to get the fibers
to grow back together so that the ligament is strong enough to function
normally. However, in some rare cases, a torn ACL may heal on its own
without being replaced. This happens very seldom, and only when the ACL
is partially torn or has pulled cleanly away from the bone.
Why have your ACL fixed?
Many people are living very
active lives for a much longer period of time then ever before. Most of
us want to be able to enjoy the activities that we like doing today for
many years to come. This may include sports that keep us fit, active,
and healthy.
Orthopedic Surgeons have
fine-tuned both the operation and rehabilitation for ACL reconstruction
surgery to the point where it can be great option for treatment. Around
90% of people who have had an ACL reconstruction are very happy and
satisfied with how their knee functions after surgery. Although ACL
surgery is not for some people, and it is certainly not a decision that
you should to rush into, you should give good thought to the surgery’s
abilities to keep you as active as possible, for as long as possible.
Medial
Collateral Ligament
The Medial Collateral Ligament
(MCL) is one of four ligaments that are important to the stability of
the knee joint. This ligament is made of tough fibrous material and
functions to control excessive motion by limiting joint mobility. The
medial collateral ligament spans the distance from the end of the
femur—known as the thigh bone—to the top of the tibia—known as the
shin bone—and is on the inside of the knee joint.
The medial collateral ligament resists widening of the inside of
the joint, and prevents opening-up of the knee.
The MCL is usually injured
when the outside of the knee joint is struck. Injury to the MCL causes
the outside of the knee to buckle, and the inside to widen. When the
medial collateral ligament is stretched too far, it is susceptible to
tearing and injury. An injury to the medial collateral ligament may
occur as an isolated injury, or it may be part of a complex injury to
the knee. Other ligaments, most commonly the anterior cruciate ligament,
or the meniscus, may be torn along with a medial collateral ligament
injury.
Treatment of an injured medial
collateral ligament
Repair of a medial
collateral ligament injury rarely requires surgical intervention. Grade
I, which are the least serious sprains of the MCL, usually resolve
within a few weeks. Resting from activity, icing the injury, and some
anti-inflammatory medications will usually be all the treatment that is
needed.
When a more serious grade II MCL sprain
occurs, use of a hinged knee brace is common in early treatment.
Athletes with a grade II injury can return to activity once they are not
experiencing pain from the MCL. When a grade III injury occurs, patients
usually wear a hinged knee brace and should not attempt to lift any heavy
weight. They should have a gradual return to normal activities. Patients
with more severe injuries usually require physical therapy and will not
return to their full level of activity for 3 to 4 months.
However, if other structures
in the knee are injured, surgery may be required. Repair of a recently
torn medial collateral ligament usually requires the surgeon to make an
incision through the skin over the area where the tear in the ligament
has occurred. If the ligament has been pulled from its attachment on the
bone, the ligament is reattached to the bone either with
large sutures,
which are strong stitches, or a special metal bone staple.
Chronic swelling or
instability caused by a medial collateral ligament injury may require surgical reconstruction. Reconstruction differs from repair of the
ligaments; a reconstruction
operation usually works by either tightening up the loose ligaments or
replacing them with a tendon graft. If a tendon graft is
needed to replace the loose ligaments, it is usually taken from somewhere
else in the same knee.
Meniscus Tear/Torn Cartilage
The meniscus is a
shock-absorbing cartilage in the middle of your knee. There are two
menisci—one on the inside (medial) and another on the outside of the
knee (lateral).
The two most common causes of
a meniscus tear are due to injury, which are often seen in athletes, and
degenerative processes, which are seen in older patients who have more
brittle cartilage. The most common type of traumatic meniscus tear occurs
when the knee joint is bent and the knee is then twisted. It is not
uncommon for the meniscus tear to occur along with injuries to the
anterior cruciate ligament (ACL) and the medial collateral ligament (MCL).
Symptoms of a Meniscus Tear
Individuals who experience a
meniscus tear usually experience pain and swelling as their major
symptoms. Another common complaint is joint locking, or the inability to
completely straighten the joint.
The most common symptoms of a
meniscus tear are:
- Knee
pain
- Swelling
of the knee
- Tenderness
when pressing on the meniscus
- Popping
or clicking within the knee
- Limited
motion of the knee joint
Surgery
Meniscus tear surgery is
usually performed arthroscopically. Arthroscopic surgery is performed on
an outpatient basis. Most
surgery for meniscus tears involves trimming the torn portion of your
meniscus. The surgeon inspects the whole knee joint to see if there
are any other problems—for example, arthritic areas, ligament tears or
tears of the other meniscus—and then evaluates the meniscal. Since a
torn meniscus is not working properly, it is only creating more damage by inflaming
the knee and irritating the cartilage near it. However, if
the meniscus is torn near its outer edge, then a meniscus repair may be
possible. Typically, the surgeon can only determine this at the time of your
arthroscopy. If possible, it is definitely in the patient's best interest to try
to repair the meniscus. Unfortunately, it is rare that a tear can
actually be repaired.
Arthroscopy
involves inserting a fiber-optic telescope that is about the size of a
pen into the joint through an incision that is about 1/8" long.
Using miniature instruments, which may be as small as 1/10",
the structures are examined and the surgery is performed.
Recovery
from removal of a meniscal tear is quick and requires the use of
crutches for longer walks only until the patient can walk without
limping, which is typically 5-7 days. With proper rehabilitation, the
patient can usually expect to return to sports activities within 4-6 weeks after
the meniscectomy.
|
Minimally
Invasive Heart Surgery
|
Recent advances in surgical techniques and
equipment allow surgeons to perform Coronary Artery Bypass Surgery in a
less traumatic way. Minimally Invasive Coronary Artery Surgery is also
called Limited Access Coronary Artery Surgery. It is as an alternative
to the standard methods of Coronary Artery Bypass Graft Surgery. Unlike
conventional surgery, which utilizes a 10-12" incision and requires the
patient to be placed on the heart-lung machine, new minimally invasive surgery may
avoid placing the patient on the machine, and can be performed
through a 3-5" incision placed between the ribs, or may be done with
several small incisions. Like conventional surgery, the surgery is done
to reroute, or bypass, blood around coronary arteries clogged by fatty
buildups of plaque and improve the supply of blood and oxygen to the
heart.
Minimally Invasive Coronary
Artery Bypass—also called MIDCAB—is
used to avoid the heart-lung machine. It's done while your heart is
still beating and is intended for use when only one or two arteries will
be bypassed. MIDCAB uses a combination of small holes, or ports, in your
chest and a small incision made directly over the coronary artery to be
bypassed. The heart surgeon usually detaches an artery from inside the
chest wall and re-attaches it to the clogged coronary artery farthest
from the occlusion. The surgeon views and performs the attachment
directly, so the artery to be bypassed must be right under the incision.
Benefits of Minimally Invasive Bypass Surgery
Minimally Invasive Bypass Surgery has the same beneficial results as
conventional bypass surgery. It restores adequate blood flow and normal
delivery of oxygen and nutrients to the heart. This type of
surgery has additional advantages, including the ability of the surgeon
to work on a beating heart or through smaller incisions.
- The procedure is performed in
only two to three hours, compared to three to six hours for a
traditional bypass.
- The recovery time is dramatically reduced from
months to
days or a week. Complications associated with the heart-lung machine
are avoided.
- Due to less time under
anesthesia, patients are moved out of intensive care more quickly.
- Patients tend to experience
less pain and discomfort.
- There is a 25-40% savings
of
the cost of conventional surgery.
- Lower
infection rate: A smaller incision
means less exposure and handling of tissue, which may reduce the
chances of infection.
- This
surgery is available to more patients. Many
patients are poor candidates for traditional bypass surgery because
their illness is too widespread or their heart is too weak. Some
patients are able to receive this life-saving surgery through
minimally invasive techniques.
Risks
Performing
surgery on a beating heart is more difficult than working on a heart
that has been stopped with the help of the heart-lung machine. In
addition, the stress on the heart during the procedure may lead to more
heart muscle damage, lower blood pressure, irregular heartbeat and
potential brain injury if blood flow to the brain is reduced for too
long during surgery. In some cases—usually less than 10 percent—it
is necessary to convert to conventional methods on an emergency basis.
|
Newest Surgical Procedures
Robotic Surgery
| Robotic surgery is a new and
very promising type of surgery. These mechanical marvels lend a helping
hand to Surgeons performing delicate and intricate surgeries. Robotic
Surgeons require a human Surgeon to operate them and input instructions
via voice activation and various computer interfaces.
Robotic technology is being
introduced in the medical field because they allow for unprecedented
control and accuracy performing surgical procedures. Robotics decrease
the fatigue that many Surgeons experience during long and tedious
operations. When Surgeons get tired it is common for them to experience
hand tremors, twitching and shaking. Robotics eliminate this by the
mechanical arm keeping steady.
The Food and Drug
Administration approved the first robotic system that is allowed to be
used in American operating rooms. It is presumed that robotic technology
could be used in over three million surgical procedures per year. As
this technology advances we believe that this will be a common
instrument in operating rooms throughout the country. |
Laser Surgery
| Lasers were developed in the
mid 1960's for industrial applications. These lasers emitted a
continuous beam of light and were nonspecific in their effects on
tissue. For the first twenty years the use of lasers in the medical
fields were limited, to say the least. In the early 1980's, lasers were
developed that emitted pulses of light. This development made the use of
lasers in medical applications popular due to the precise and effective
results of this new technology.
Today, many surgical
procedures are performed by lasers. Lasers are used to cut, coagulate,
vaporize and remove tissue. Lasers are used are for open and
laparoscopic procedures as well as breast surgery, gallbladder removal,
hernia repair, bowel resection, hemorrhoidectomy, solid organ surgery
and pilonidal cyst.
Dermatologists use lasers for
many medical applications. These applications include:
| Benign Skin Growths
Stretch Marks
Unwanted Hair
Enlarged blood
vessels
Birthmark removal
Tattoo removal
Scar removal |
Ophthalmologists use lasers
frequently. The excimer laser is used to reshape the cornea and help the
eye focus properly. Laser vision correction is used to correct
nearsightedness, farsightedness and even astigmatism. Retina specialists
are using lasers to help treat Macular Degeneration. Glaucoma and other
diseases that cause pressure on the eye is now treated with lasers
Urologists are utilizing
lasers in the treatment of diseases that affect the urinary and genital
systems. Common diseases that are treated are urinary tract disorders,
urinary stones, urothelial tumors, obstructions, tumors and warts.
Podiatrists use lasers to treat fungal nails; ingrown nails; deformed
nails; Plantar warts; skin fissures; certain types of cysts, and many
other conditions.
With the continuing
advancements of laser technology and the advantages minimal invasive
surgery we expect see many new advances in this field. |
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