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Should a robot perform your surgery?

Robotic surgery - the term implies some futuristic concept, a la the “Jetsons” or Isaac Asimov. As someone who was a science fiction fan growing up, I never thought I’d actually spend every day of my professional life answering this question.

As a gynecologic oncology surgeon, this is a question I now ask myself every time I pick up a patient’s chart. And the answer more times than not is YES! Why?

Your Multidisciplinary Surgical Care Team

It can be overwhelming and confusing to have numerous professionals involved in your care when you undergo surgery. Your surgeon, also known as the “attending” surgeon, oversees your total care when you have surgery. In addition to your attending surgeon you will encounter many different people during your hospitalization who are invested in your care. The following is meant to familiarize you with professionals you may encounter during your hospital experience.

Your Surgical Team

Thoracic Surgeons, Fellows, and Residents

We take pride and are highly invested in teaching at Swedish. As part of this dedication to teaching we (the Thoracic Surgery team at Swedish) participate in an accredited training program for thoracic and esophageal “fellows”. Our fellows are surgeons seeking additional advanced surgical instruction in this specialized field of thoracic and esophageal surgery.

Swedish has a robust surgical residency training program which includes time spent on our service. There is always a senior surgical resident assigned to our team involved in the daily care of our patients.

During your hospitalization and follow-up care you will routinely encounter the attending surgeon, fellow, and resident daily. In the event that your attending surgeon is away, your care will be directed by one of our other thoracic surgical attending physicians.

Interventional Pulmonologist

Our Thoracic Surgery team also includes an airway specialist (Interventional Pulmonologist) who understands complex airway problems and specializes in advanced diagnostic and therapeutic techniques to treat patients with cancer, airway disorders, and pleural disease. This specialist collaborates closely with our Thoracic Surgery team, a team of medical oncologists, and radiation oncologists to improve the care of our patients.

Thoracic Surgery Nurses

Nurses at the bedside are integral in our care delivery during your hospitalization. We value the twenty-four hour expert care that our specially trained nurses offer and work closely with them to provide you a positive experience.

Thoracic Surgery Nurse Practitioners

Our team also includes two expert nurse practitioners. Nurse practitioners are nurses who have graduate level training in specific areas of adult and acute care medicine. These nurse practitioners work closely with the surgeons and nursing staff in your overall care management, educate you about your health condition(s), and work with you in managing health concerns following surgery. They facilitate your transition of care to home and support you in the early post-operative period.

Additional Support Professionals

We commonly call on the expertise and help of other health care professionals while you are in the hospital, such as:

Nutritionists

Many of our patients come to us in a compromised health state. We will often consult with our nutritionists for their recommendations and approaches to provide you with the nutritional support required to improve your nutritional state and support your recovery.

Physical and Occupational Therapists

Physical and occupational therapists are vital in the care of our patients. They provide assessments and recommendations for rehabilitation and work with us to restore your physical and functional capacity following surgery.

Respiratory Therapists

Respiratory therapists are also extraordinarily vital in the care of our patients. They work hard to assess and maintain pulmonary hygiene and optimize your breathing status following surgery.

We believe that by incorporating a multidisciplinary team of health care professionals into your surgical care we can offer you the continuity and quality of care that you deserve.

Do you have questions about multidisciplinary health care teams? Or, have you ever experienced multidisciplinary care teams? Please share your experiences and questions with us.

Personalized medicine is the future of healthcare

If you were diagnosed with cancer or another disease, wouldn’t you want your treatment and medicines to be as unique as you are?

This is a growing trend in medicine where the type of treatment a patient gets depends on their DNA.

A few weeks ago, Dr. Hank Kaplan of the Swedish Cancer Institute spoke with KING5 about the I-SPY clinical trial (click here to watch the KING5 story).

The usual treatment for breast cancer may be surgery, followed by chemotherapy, possibly radiation and as a last resort, a clinical trial.

The I-SPY clinical trial turns that thinking upside down by actually extracting DNA from a tumor to figure out which new drug will likely work best, then giving it to the patient first, even before surgery.

"The goal of the I-SPY trial is really to develop a faster and cheaper way to develop new drugs for breast cancer . We're hoping that this is a new paradigm that will work for other kinds of cancer too," said Dr. Kaplan.

Are you ready for surgery?

I am a nurse practitioner and one of my jobs is to help patients through their surgical experience with us. Here are some of the things you should know before surgery:

Communication

Surgery can be a very stressful event, and thinking about it may cause some anxiety. The best way to prepare for surgery is through education. Make sure that you have talked to all of your doctors so that you are making an informed decision about surgery. We will collaborate with your primary care physician and your cardiologist, but we encourage you to communicate with your entire medical team as well.

Education

Learn about your surgery, what your hospital stay will be like, and what you can expect during recovery. The more relaxed and confident you are going into surgery, the better your chances of a successful and comfortable experience.

Diet

Cutting Edge Concept in the Treatment of tongue, tonsil, and throat cancer

Cancers of the tongue, tonsil, and throat are being diagnosed at an increasing rate, even in the non-smoking population. Transoral Laser Microsurgery (TLM) and Trans Oral Robotic Surgery (TORS) are some of the newest intervention available for patients with these cancers.

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During my first 3 years of medical school in Cleveland, I frankly did not know anything about cancers of the mouth and throat (otherwise called "Head & Neck Cancer").  Really, I did not know you could get cancer in the tongue or tonsil!  It wasn't until the final year of medical school that I was exposed to the field of Head & Neck Surgery, that I realize the impact of these cancers on the quality of life of patients.

Those cancers are generally not featured in the media, and I would argue that most of us will live a lifetime without meeting more than a handful of patients who have this type of cancer.  There is no marathon, 10K walk, or charity gala on behalf of Head & Neck Cancer... right?  Well, we did have some high-profile patients in the past few years.  We all remember Michael Douglas (actor), George Karl (former coah of the now defunct Supersonics...moment of silence), and Roger Ebert (movie critic)...

Well, this type of cancer is now being diagnosed at an increasing rate.  And not just in the smoking population!  We are now seeing many young patients, who have never smoked, who get diagnosed with Head & Neck cancer.  I mean, we are talking about patients in their 20's and 30's!  This is possibly due to generational lifestyle changes, as there is now strong scientific evidence that certain types of HPV (Human Papilloma Virus) are causing this cancer.  Yes... It's the same virus that causes cervical cancer in women.  This topic probably warrants its own separate blog, and I'll get on it next time!

The symptoms, diagnosis, and pathophysiology of this cancer is beyond the scope of this blog.  If you want to know more about symptoms, diagnosis, etc..., just leave a comment, and I'll try to answer your questions and comments as promptly as possible. 

The goal of this blog is to highlight some of the new treatment paradigm for this type of cancer.  More specifically, new minimally invasive surgical procedures called Transoral Laser Microsurgery (TLM) and Trans Oral Robotic Surgery (TORS).

Traditionally, Head & Neck cancers require either major surgery or intense chemo-radiation, or sometimes even a combination of surgery and chemo-radiation.  Surgery will often result in difficulty swallowing and speaking.  Chemo-radiation has improved results in swallow and speech, but even the non-surgical treatment protocol will often leave the patient with significant deficit.   

So what are the new options?  What if we could remove the cancers through the mouth?  What if we didn't have to break open the lip and jaw to get to the throat?  What if we could excise the cancer and still allow the patient to swallow and talk normally?  What if we could decrease the amount of radiation and chemo?  Well, many innovators have asked themselves these questions, and we have now some answers to these questions.  Evolving answers, obviously, as new technology will continuously allow us to push the cutting edge even further.

Miss out on Swedish's live knee surgery? Watch the recap today.

If you missed out on Swedish's live knee surgery in March, we have a recap for you - but five minutes of video instead of the five hours originally streamed!

On Tuesday, March 15, 2011, surgeons from the Swedish Orthopedic Institute offered the opportunity to see a knee surgery in a way that has rarely been done before by a healthcare system. Sean Toomey, MD, an orthopedic surgeon, repaired the knee of a patient, streamed live online. The webcast was moderated by orthopedic surgeon James Crutcher, MD. The patient, identified by Dr. Toomey as a candidate for a partial knee replacement procedure, volunteered and consented to have his knee replacement surgery streamed live.

The live webcast provided a rare front row seat into advances in surgical technology, featuring new robotic-assisted technology for knee replacements. During the surgery, the video portion of the webcast was embedded below, and was accompanied by a live chat. Viewers sent questions during the procedure using the live chat features (no login or account needed) or via Twitter using hash tag #livekneesurgery and were answered by the narrating physician during the webcast. Anyone interested in learning about orthopedic options at Swedish or surgical technology were encouraged to join the web stream.

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