Brian Louie
Brian E. Louie, M.D.

Brian E. Louie, M.D.

Brian E. Louie, M.D.
Specialty

Esophageal Surgery, Robotic Surgery, Thoracic Surgery

Clinical Interests / Special Procedures Performed

Bronchoscopy, Chest Wall Tumors, da Vinci (Robot-Assisted Surgery), Endoscopic Surgery, Endoscopy, Esophageal Achalasia, Esophageal Cancer, Esophagectomies, Gastro-Esophageal Junction, Gastro-Esophageal Reflux, Laparoscopic Surgery, LINX System, Lung Cancer, Mediastinal Masses, Minimally Invasive Surgery, Myasthenia Gravis, Thoracoscopic Lobectomies, Thorascopic Surgery, Thymoma, Tracheal Problems

  • Accepting Children: No
  • Accepting New Patients: Yes
  • Accepting Medicare: Yes
  • Accepting Medicaid/DSHS: Yes
Payment Methods Accepted:

Medicare, Medicaid/DSHS, Bill Insurance, VISA, Master Card, Cash, Check, American Express, Discover Card, Money Order

Insurance Accepted:

Contact this office for accepted insurance plans.

Additional Information:

 

Appointments

Co-Medical Director, Endoscopy Unit - Swedish Medical Center

Co-Director, Minimally Invasive Thoracic Surgery Program - Swedish Medical Center

Clinical Instructor, General Surgery Residency Program - Swedish Medical Center

Director of Research and Education, Division of Thoracic Surgery - Swedish Cancer Institute and Medical Center


Videos

LINX (a newly FDA-approved device for acid reflux or gastroesophageal reflux disease (GERD))

New device for acid reflux

Esophageal Cancer

Tanya Gularte & Dr. Louie's Story, Esophageal Cancer Survivor

Introduction: Esophageal Cancer

Barrett's Esophagus

What are the problems with a Barrett's Esophagus surveillance only strategy?

Under the Barrett’s study at Swedish, who are potential candidates for treatments?

What options exist to treat Barrett’s Esophagus?

What should I expect before/during/after my Radiofrequency Ablation (RFA) procedure?

What are my options if my Barrett’s Esophagus has turned into cancer?

Robotic Surgery

What are the surgical options to treat myasthenia gravis, and to remove thymomas?

What is the thymus gland?

What is thymoma?

What is myasthenia gravis?

What are the risks of robotic thymectomy?


Professional Highlights

 

Dr. Louie was voted "Top Doctors" in Seattle Magazine (2013, 2014).

Surveys were mailed to physicians in King, Pierce, Snohomish and Kitsap counties. The survey asked physicians to name the provider they would seek out or recommend to loved ones.

News Release

DaVinci - Surgeons from Swedish are First in Seattle to Begin Performing Robotic-Assisted Thoracic Surgery

KOMO Television (Channel 4; ABC)

"We are the first in Washington state to do minimally invasive - or video-assisted thoracic surgery lobectomies, and we recently became the first surgical group in Seattle to use the daVinci system for thoracic (chest) surgery." ... Watch Video


King 5 HealthLink: New procedure could provide fix for severe acid reflux

Until now, people with severe acid reflux haven't had many options. Medications don't always work and have side effects. The same is true of surgical options, but a new procedure could change that and has the science to back it up. Watch Video
 

Dr. Louie was voted "Top Doctors" in Seattle Metropolitan Magazine (2009, 2010, 2012)

Nearly 4,500 physicians, nurses and physician assistants in King, Kitsap and Snohomish counties nominated colleagues they would choose to treat themselves and their loved ones. 

News Release

Invited Lecturer - Society for Thoracic Surgery/Tech Con Meeting 2011

"Should Robotic Thoracic Surgery Be Pursued? A case-control analysis of selected robotic versus laparoscopic/VATS procedures "

Society for Thoracic Surgery/American Association of Thoracic Surgery Tech Con 2011. San Diego, CA. January 29, 2011

Invited Lecturer - The Asian Society of Cardiovascular and Thoracic Surgery in Singapore

"Expert Techniques in VATS Lobectomy - Pitfalls and Pearls."
"Integrating EBUS into a Lung Cancer Program - Using a technology assessment approach."
"Minimal Access Surgery of the Mediastinum - A new era?"

The Asian Society of Cardiovascular and Thoracic Surgery. Singapore. March 14-16, 2008.

 

Personal Interests

Sports - Ice Hockey, Mountain Biking, Golf, Volleyball, Weight Lifting, Snowboarding and Skiing; Travel - Canada, United States, Japan, China, Taiwan, Europe, Caribbean, Mexico, Singapore, Tunisia

Medical School

University of Toronto

Residency

University of Alberta - General Surgery

Fellowship(s)

Thoracic Surgery - McMaster University, Esophageal and Gastric Surgery - University of Southern California

Board Certifications

Royal College of Physicians and Surgeons - General Surgery; Royal College of Physicians and Surgeons - Thoracic Surgery; American Board of Surgery - General Surgery

Awards:

Top Doctors 2009 & 2010 - Seattle Metropolitan Magazine

Additional Information:

 

Appointments

Co-Medical Director, Endoscopy Unit - Swedish Medical Center

Co-Director, Minimally Invasive Thoracic Surgery Program - Swedish Medical Center

Clinical Instructor, General Surgery Residency Program - Swedish Medical Center

Director of Research and Education, Division of Thoracic Surgery - Swedish Cancer Institute and Medical Center


Videos

LINX (a newly FDA-approved device for acid reflux or gastroesophageal reflux disease (GERD))

New device for acid reflux

Esophageal Cancer

Tanya Gularte & Dr. Louie's Story, Esophageal Cancer Survivor

Introduction: Esophageal Cancer

Barrett's Esophagus

What are the problems with a Barrett's Esophagus surveillance only strategy?

Under the Barrett’s study at Swedish, who are potential candidates for treatments?

What options exist to treat Barrett’s Esophagus?

What should I expect before/during/after my Radiofrequency Ablation (RFA) procedure?

What are my options if my Barrett’s Esophagus has turned into cancer?

Robotic Surgery

What are the surgical options to treat myasthenia gravis, and to remove thymomas?

What is the thymus gland?

What is thymoma?

What is myasthenia gravis?

What are the risks of robotic thymectomy?


Professional Highlights

 

Dr. Louie was voted "Top Doctors" in Seattle Magazine (2013, 2014).

Surveys were mailed to physicians in King, Pierce, Snohomish and Kitsap counties. The survey asked physicians to name the provider they would seek out or recommend to loved ones.

News Release

DaVinci - Surgeons from Swedish are First in Seattle to Begin Performing Robotic-Assisted Thoracic Surgery

KOMO Television (Channel 4; ABC)

"We are the first in Washington state to do minimally invasive - or video-assisted thoracic surgery lobectomies, and we recently became the first surgical group in Seattle to use the daVinci system for thoracic (chest) surgery." ... Watch Video


King 5 HealthLink: New procedure could provide fix for severe acid reflux

Until now, people with severe acid reflux haven't had many options. Medications don't always work and have side effects. The same is true of surgical options, but a new procedure could change that and has the science to back it up. Watch Video
 

Dr. Louie was voted "Top Doctors" in Seattle Metropolitan Magazine (2009, 2010, 2012)

Nearly 4,500 physicians, nurses and physician assistants in King, Kitsap and Snohomish counties nominated colleagues they would choose to treat themselves and their loved ones. 

News Release

Invited Lecturer - Society for Thoracic Surgery/Tech Con Meeting 2011

"Should Robotic Thoracic Surgery Be Pursued? A case-control analysis of selected robotic versus laparoscopic/VATS procedures "

Society for Thoracic Surgery/American Association of Thoracic Surgery Tech Con 2011. San Diego, CA. January 29, 2011

Invited Lecturer - The Asian Society of Cardiovascular and Thoracic Surgery in Singapore

"Expert Techniques in VATS Lobectomy - Pitfalls and Pearls."
"Integrating EBUS into a Lung Cancer Program - Using a technology assessment approach."
"Minimal Access Surgery of the Mediastinum - A new era?"

The Asian Society of Cardiovascular and Thoracic Surgery. Singapore. March 14-16, 2008.

 

Early Experiences with Robotic Lung Resection Result in Similar Operative Outcomes and Morbidity When Compared to Matched VATS Cases 

     Louie BE, Farivar AS, Aye RW, Vallières E.

 

      "Early experience with robotic resection resulted in similar outcomes compared with mature
       VATS cases. A potential benefit of robotics may relate to postoperative pain reduction and earlier
       return to usual activities..."
(PudMed)

       Annals of Thoracic Surgery. 93(5):1598-605, 2012

Repair of Symptomatic Giant Paraesophageal Hernias in Dlderly (> 70 yrs) Patients Results in Improved Quality of Life

          Louie BE, Blitz M, Orlina J, Farivar AS, Ralph AW.

         "Symptomatic giant PEH in this elderly population can be repaired with symptomatic
          improvement, minimal morbidity and mortality in both the elective and urgent setting. The
          decision to operate should be made by a physician experienced in managing this complex
          patient population."
(PubMed)

          Journal of Gastrointestinal Surgery. Volume 15(3): 389-96, 2011

Comparison of Open and Minimally Invasive Thymectomies at a Single Institution

         Youssef S, Louie BE, Blitz M, Farivar AS, Aye RW, Vallières E.

         "Minimally invasive thymectomy can be performed with similar morbidity and efficacy as
          transsternal thymectomy. Patients require fewer narcotics and can be discharged earlier."
         
(PubMed)

         The American Journal of Surgery. 199(5):589-593, 2010

 

Safety and Utility of Mediastinoscopy in Non-Small Cell Lung Cancer in a Complex Mediastinum

          Louie BE, Kapur S, Farivar AS, Youssef S, Gorden J, Aye RW, Vallières E

          " Mediastinoscopy in the complex mediastinum can be 
           performed with acceptable morbidity" 

           View presentation

           Southern Thoracic Surgical Association. Orlando, Florida
           November 5, 2010


________________________________________

 

PUBLICATIONS:

Lipham JC, Taiganides PA, Louie BE, Ganz RA, Demeester TR. Safety analysis of first 1000 patients treated with magnetic sphincter augmentation for gastroesophageal reflux disease. Dis Esophagus. 2014 Mar 11.
 
Farivar AS, Cerfolio RJ, Vallières E, Knight AW, Bryant A, Lingala V, Aye RW, Louie BE.  Comparing robotic lung resection with thoracotomy and video-assisted thoracoscopic surgery cases entered into the society of thoracic surgeons database.  Innovations (Phila). 2014 Jan-Feb;9(1):10-5.
 
Deen SA, Wilson JL, Wilshire CL, Vallières E, Farivar AS, Aye RW, Ely RE, Louie BE. Defining the Cost of Care for Lobectomy and Segmentectomy: A Comparison of Open, Video-Assisted Thoracoscopic, and Robotic Approaches. Ann Thorac Surg. 2014 Mar;97(3):1000-7.
 
Deen S, Farivar AS, Louie BE. Thoracic techniques: robotic thymectomy for thymoma. Indian J Surg Oncol. 2013 Jun;4(2):132-7.
 
Louie BE. Robotic Lobectomy for Non-Small Cell Lung Cancer.  Indian J Surg Oncol. 2013 Jun;4(2):125-131.
 
Jutric Z, Louie BE. Laparoscopic paraesophageal hernia repair. Surg Laparosc Endosc Percutan Tech. 2013 Oct;23(5):436-41.
 
Wilson JL, Louie BE, Farivar AS, Vallières E, Aye RW. Fully covered self-expanding metal stents are effective for benign esophagogastric disruptions and strictures. J Gastrointest Surg. 2013 Dec;17(12):2045-50.
 
Wechsler ME, Laviolette M, Rubin AS, Fiterman J, Lapa e Silva JR, Shah PL, Fiss E, Olivenstein R, Thomson NC, Niven RM, Pavord ID, Simoff M, Hales JB, McEvoy C, Slebos DJ, Holmes M, Phillips MJ, Erzurum SC, Hanania NA, Sumino K, Kraft M, Cox G, Sterman DH, Hogarth K, Kline JN, Mansur AH, Louie BE, Leeds WM, Barbers RG, Austin JH, Shargill NS, Quiring J, Armstrong B, Castro M; Asthma Intervention Research 2 Trial Study Group. Bronchial thermoplasty: Long-term safety and effectiveness in patients with severe persistent asthma. J Allergy Clin Immunol. 2013 Dec;132(6):1295-302.
 
Hunt BM, Louie BE, Dunst CM, Lipham JC, Farivar AS, Sharata A, Aye RW. Esophagectomy for failed endoscopic therapy in patients with high-grade dysplasia or intramucosal carcinoma. Dis Esophagus. 2013 Jun 24.
 
Hunt BM, Louie BE, Schembre DB, Bohorfoush AG, Farivar AS, Aye RW. Outcomes in patients who have failed endoscopic therapy for dysplastic Barrett's metaplasia or early esophageal cancer. Ann Thorac Surg. 2013 May;95(5):1734-40.
 
Louie BE. Robotic lobectomy - the future of minimally invasive lobectomy? Chin J Cancer Res. 2013 Feb;25(1):1-3.
 
Qureshi AP, Aye RW, Buduhan G, Knight A, Orlina J, Farivar AS, Wagner OJ, McHugh S, Louie BE. The laparoscopic Nissen-Hill hybrid: pilot study of a combined antireflux procedure. Surg Endosc. 2013 Jun;27(6):1945-52.
 
Louie BE, Kapur S, Blitz M, Farivar AS, Vallières E, Aye RW. Length and pressure of the reconstructed lower esophageal sphincter is determined by both crural closure and Nissen fundoplication. J Gastrointest Surg. 2013 Feb;17(2):236-43.
 
Aye RW, Swanstrom LL, Kapur S, Buduhan G, Dunst CM, Knight A, Malmgren JA, Louie BE. A randomized multiinstitution comparison of the laparoscopic Nissen and Hill repairs. Ann Thorac Surg. 2012 Sep;94(3):951-7
 
Wagner OJ, Louie BE, Vallières E, Aye RW, Farivar AS. Near-infrared fluorescence imaging can help identify the contralateral phrenic nerve during robotic thymectomy. Ann Thorac Surg. 2012 Aug;94(2):622-5.
 
Egan M, Louie BE, Farivar AS, Wagner O, Vallières E. Laparoscopic repair of gastric herniation after extrapleural pneumonectomy for mesothelioma. Ann Thorac Surg. 2012 May;93(5):e127-9.
 
Hunt BM, Farivar AS, Vallières E, Louie BE, Aye RW, Flores EE, Gorden JA. Thoracoscopic talc versus tunneled pleural catheters for palliation of malignant pleural effusions. Ann Thorac Surg. 2012 Oct;94(4):1053-7.

Louie BE, Farivar AS, Aye RW, Vallières E. "Early Experiences with Robotic Lung Resection Result in Similar Operative Outcomes and Morbidity When Compared to Matched VATS Cases". Annals of Thoracic Surgery. 93(5):1598-605, 2012. (PubMed)

Louie BE, Kapur S, Farivar AS, Youssef SJ, Gorden J, Aye RW, Vallières E. Safety and Utility of Mediastinoscopy in Non-Small Cell Lung Cancer in a Complex Mediastinum. Annals of Thoracic Surgery, 2(1): 278-82, 2011. (PubMed)

Louie BE, Blitz M, Orlina J, Farivar AS, Ralph AW. "Repair of symptomatic giant paraesophageal hernias in elderly (> 70 yrs) patients results in improved quality of life". Journal of Gastrointestinal Surgery. Volume 15(3): 389-96, 2011. (PubMed)

Youssef S, Louie BE, Blitz M, Farivar AS, Aye RW, Vallières E. “Comparison of open and minimally invasive thymectomies at a single institution.” The American Journal of Surgery. 199(5):589-593, 2010. (PubMed)

Louie BE. "Is esophagectomy the paradigm for volume-outcome relationships?" Journal of Gastrointestinal Surgery. 14(Supplement 1):115-120, 2010

Buduhan G, Louie BE, Orlina J, Vallières E, Aye RW."Endoscopic and manometric position-related characteristics of the normal gastroesophageal junction." Surgical Endoscopy. 24:2165–2169, 2010

Buduhan G, Menon S, Aye RW, Louie BE, Mehta V, Vallières E. “Trimodality therapy for malignant pleural mesothelioma.” Annals of Thoracic Surgery. (88):870-876, 2009

Hunt BM, Vallières E, Buduhan G, Aye RW, Louie BE. “Sarcoidosis as a benign cause of lymphadenopathy in cancer patients.” The American Journal of Surgery. 197(5):629-32, 2009

Hochman D, Louie BE, Bailey R. "Determination of patient quality of life following severe acute pancreatitis." Canadian Journal of Surgery. 49(2):101-6, 2006

Click here for all publications

________________________________________

PRESENTATIONS:

Louie BE, Farivar AS, Aye RW, Vallières E. "Early Experience With Robotic Lung Resection Results In Similar Operative Outcomes and Morbidity When Compared To Matched VATS Cases ." Southern Thoracic Surgical Association. San Antonio, Texas, November 11, 2011

Louie BE. "Surgical Alternatives and Modifications in the Management of PEH." Panel Discussion – Seattle Surgical Society. Seattle, WA, April 29, 2011

Louie BE. “Robotic Surgery for Lung Cancer.” Society for Thoracic Surgery/American Association of Thoracic Surgery Tech Con 2011. San Diego, CA. January 29, 2011

Louie BE, Farivar AS, Wagner O, Aye RW, Hopper P, Witmer K, Thirsk-Fathi J, Vallières E. "Should Robotic Thoracic Surgery Be Pursued? A case-control analysis of selected robotic versus laparoscopic/VATS procedures" (Abstract), The International Society for Minimally Invasive Cardiothoracic Surgery. Washington DC. June 8, 2010

Louie BE, Kapur S, Farivar AS, Youssef S, Gorden J, Aye RW, Vallières E. "Safety and Utility of Mediastinoscopy in Non-Small Cell Lung Cancer (NSCLC) in a Complex Mediastinum". Southern Thoracic Surgical Association. Orlando, Florida November 5, 2010

Kapur S, Farivar AS, Orlina J, Aye RW, Louie BE. “Evaluation and approach to benign distal esophageal and gastroesophageal junction lesions.” 12th World congress of The International Society for Diseases of the Esophagus. Kagoshima, Japan. September, 2010

Brandi P, Blitz M, Louie BE, Aye RW, Vallières E. “Pulmonary Resection of NSCLC can be performed safely following definitive chemoradiotherapy.” Oral presentation 13th World Conference on Lung Cancer. San Francisco, CA. 2009

Youssef S, Blitz M, Valliéres E, Aye RW, Louie BE. "Preliminary experience with minimally invasive thymectomy." Washington Chapter of the American College of Surgeons. Lake Chelan, WA. June 14, 2009

Louie BE, Dunst CM, Swanstrom L, Aye RW. "Manometric Features of the Laparoscopic Hill repair vs the Nissen Fundoplication for Gastroesophageal Reflux Disease (GERD)." Digestive Diseases Week. Chicago. Illinois, June 1, 2009

Louie BE. "Barrett's esophagus, high grade dysplasia and intramucosal carcinoma - A continued role for surgery." Emil Jobb Gastroenterology Symposium: Update on Gastrointestinal and Liver Disease. Seattle, Washington. February 27, 2009

Buduhan G, Menon S, Aye RW, Louie BE, Mehta V, Valliéres E. "Trimodality therapy for malignant pleural mesothelioma." Society for Thoracic Surgery. San Francisco, California. January 27, 2009

Hunt BM, Valliéres E, Buduhan G, Aye RW, Louie BE. "Sarcoidosis as a benign cause of lymphadenopathy in cancer patients." North Pacific Surgical Association. Seattle, Washington. November 15, 2008

Buduhan G, Louie BE, Vallières E, Orlina J, Aye RW. "The Right Lateral Decubitus Position is Associated with a Weakened Lower Esophageal Sphincter - Position Related Physiology of the Normal Gastroesophageal Junction." International Society for Diseases of the Esophagus. Budapest. September 2008

Gordon J, Louie BE, Orlina J, Daniel S, Vallières E, Rees J, Aye RW. "The Nissen-Hill 'hybrid' - Pilot study of a new antireflux repair." International Society for Diseases of the Esophagus. Budapest. September 2008

Louie BE, Daniel S, Wada E, Tennent N, Vallières E, Aye RW. "Lessons learned from 110 consecutive VATS lobectomies for primary, early-stage non-small cell lung cancer."(Poster Presentation). American Society of Clinical Oncology - ASCO. Chicago. May 2008

Louie BE. "Is esophagectomy the paradigm for volume-outcome relatonships?" Tom R. DeMeester Festschrift. Pasadena, California. May 15-16, 2008

Louie BE. "Expert Techniques in VATS Lobectomy - Pitfalls and Pearls." The Asian Society of Cardiovascular and Thoracic Surgery. Singapore. March 14-16, 2008

Louie BE. "Integrating EBUS into a Lung Cancer Program - Using a technology assessment approach." The Asian Society of Cardiovascular and Thoracic Surgery. Singapore. March 14-16, 2008

Click here for all presentations

________________________________________

BOOK CHAPTERS:

Louie BE, Vallières E, Vallières E. Esophagectomy for Primary and Secondary Motility Disorders. In Adult Chest Surgery, 2nd Edition. David Sugarbaker MD Ed. In Press 2012.

Hunt B, Brian E. Louie. Surgery for Lung Cancer. In Lung Cancer Choices. Cindy Langerholm. Ed. In press 2012.

Louie BE, Vallières E. Cooperative Clinical Trials in Thoracic Oncology. In Cardiothoracic Surgery Review. Kenneth L. Franco & Vinod H. Thourani, eds. Philadelphia. Lippincott, Williams and Wilkins. pp. 1448-54, 2012

Kapur S, Louie BE. Hemoptysis and Thoracic Fungal Infections. Surgical Clinics of North America. Volume 90:985-1001, 2010

Blitz M, Louie BE. Chronic Traumatic Diaphragmatic Hernias. Thoracic Surgical Clinics. 19(4):491-500, 2009

Louie BE, Vallières E. Diagnostic Procedures for Pleural Disease in Thoracic Surgery. In Patterson GA, Pearson FG, Cooper JD, Deslauriers J, Rice TW, Luketich JD, Lerut A (editors), Thoracic Surgery, Third Edition. Churchill Livingstone, Chapter 84:1033-41, April 2008

Louie BE, DeMeester S. Colon Replacement. In Patterson GA, Pearson FG, Cooper JD, Deslauriers J, Rice TW, Luketich JD, Lerut A (editors), Esophageal Surgery, Third Edition. Churchill Livingstone, Chapter 59, pp. 630-642, April 2008

Hagen JA, Louie BE. Carcinoma of the esophagus and gastroesophageal junction. In Shackelford's Surgery of the Alimentary Tract. Yeo CJ, Peters JH, Dempsey DT (editors) Philadelphia. pp. 465-486, 2007

 

 

Per Oral Endoscopic Myotomy (POEM) for achalasia

P.O.E.M. has come to Seattle at Swedish Medical Center.  No, not the kind that rhymes but one that is elegant in its own way.  Per Oral Endoscopic Myotomy or POEM is relatively new procedure used in the treatment of achalasia, which is a disorder of the esophagus due to degeneration of the nerve network within the walls of the esophagus.  The diseases leaves patients with little propulsive power to push food toward and into the stomach as well as causing the “valve” at the top of the stomach to remain closed.  This makes it difficult for patients to eat or drink.   Patients may need to drink a lot of fluid to get food to pass into the stomach whereas others may feel pain or discomfort after eating and still others may have undigested food come up many hours after eating or when lying down.
 
The treatment for achalasia is ...

Research on LINX recently published

The Swedish Thoracic Surgery team recently had results from a study published in Annals of Thoracic Surgery, "Short-Term Outcomes Using Magnetic Sphincter Augmentation Versus Nissen Fundoplication for Medically Resistant Gastroesophageal Reflux Disease", in which a retrospective case-control study was performed of consecutive patients undergoing either procedure who had chronic gastrointestinal esophageal disease (GERD) and a hiatal hernia of less than 3 cm. Based on the study, the LINX device appears to restore the sphincter barrier function and preserve normal physiology which enables belching and vomiting.

Updates on LINX - GERD reflux management system

Since my initial LINX blog post 20 months ago, we have been engaged in a dialogue with patients from around the world who suffer from gastroesophageal reflux disease or GERD.  Despite my initial trepidation to “blogging”, this has been a rewarding experience to hear about patient’s problems, their concerns about the current treatments (PPI’s and Nissen fundoplication) and simply interacting with them.  I thank the patients who have taken time to share their thoughts on the blog.

 

When our social media manager asked me to provide an update on LINX, I realized that I have been simply responding to patient’s questions and I haven’t posted any of my thoughts or updates on what is happening with the LINX device.

There are some exciting developments for patients who are interesting in having a LINX implanted.

 
Use of MRI and LINX
  • Torax, the company who designed and manufactures the LINX device, has received FDA support for the use of MRI with the LINX device.  This conditional approval allows for patients to undergo and MRI that is 0.7 Tesla or less.   I am trying to clarify with our radiologists what a 0.7 Tesla MRI will cover.
Medicare coverage
 
  • For medicare patients, LINX now has a dedicated procedure code that allows for payment to cover the cost of the hospital portion of implanting the LINX device.  The surgeon’s fee is a separate code and fee and is usually covered.
Insurance update
 
  • For patients with non-medicare insurance, the ...

Dysphagia - what it is, what can be done, and why you should speak with your provider if you have trouble swallowing

Dysphagia. This is the technical medical term for difficulty swallowing which is a common complaint. Most people have experienced this sensation in their lives. It can occur when you’re eating something doughy like a bagel or French bread and then take few extra bites before swallowing. If you immediately swallow several times in a row you may get the sensation that the food is slowly passing toward your stomach. Your mouth may salivate; you might get a pressure sensation behind your breastbone; you might experience some pain, burning or discomfort. And, then you will feel instant relief the second the food you swallowed passes from the esophagus into the stomach. This is dysphagia.

For most people, this experience occurs very occasionally and usually when we are trying to eat too much, too quickly.

However, for some patients this symptom may occur more frequently such as daily and sometimes as often as every bite of food. It may also occur with solid food alone or with both solids and liquids. Most people will hope that the symptom will resolve by itself. Over time, they will often change the way they eat to avoid the symptom. They will eat slowly and chew their food till it resembles a paste, or they will use water to make things runny which then allows the food to pass.

What is interesting is that patients are reluctant to see or discuss this symptom with their physicians. In the last few months, I have seen patients who have had the symptom of dysphagia anywhere from 1 year to 40 years before they believed it was important enough to seek medical advice. The simple truth is that dysphagia that happens regularly or requires changes in the way you eat should be reported to a physician to determine the cause of the trouble.

What causes dysphagia?

There ...

Upcoming GERD talk at Swedish Issaquah on 9/26

LINX has arrived at Swedish! After several months of preparation, we will be implanting the first 3 LINX devices on September 21, 2012. For our 3 adventurous patients, we are excited to see them have their GERD controlled with the LINX and also hope that it meets their expectations.

To learn more about this procedure and others options for managing GERD, you may wish to come and hear my partners Dr. Ralph Aye and Dr. Alex Farivar talk at Swedish Issaquah on September 26th, 2012. For more information and to register for the 9/26 GERD class, click here.

Update on 9/23: I am happy to report that our patients who have received the LINX device are all doing well.

A new treatment for GERD: The LINX - Reflux Management System

Acid reflux, heartburn and indigestion are all forms of gastroesophageal reflux disease or GERD. This common problem afflicts over 20 million people in the United States on a daily basis. As a surgeon who treats patients with some of the most severe symptoms of GERD, I was recently struck by the fact that very little has changed in the treatment of the debilitating problem over the last several decades.

Medications have always been the primary treatment for patients with GERD. TUMS, Rolaids, alka seltzer are easy over the counter remedies that could provide instant but only short-term relief. More potent medications called H2 receptor antagonists (commonly known as Zantac, Pepcid AC) brought about longer lasting relief. These medications were great but many patients experienced a relapse of symptoms.

The newest medications for GERD...

Using robotic technology to improve outcomes in myasthenia gravis and thymoma

New technologies have the potential to improve patient outcomes but need to be carefully studied so that patients will maximally benefit.  Robotic thymectomy for myasthenia gravis and thymomas was introduced at Swedish in May of 2009 after careful evaluation of our outcomes with traditional sternotomy and VATS thymectomy.

One of the more challenging aspects of being a surgeon is to understand how new technologies can benefit your patients and how those technologies might become part of your practice. If you’ve watched Grey’s Anatomy, read Time magazine or the Wall Street Journal or surfed the web recently, you’ll be aware of the da Vinci surgical robot. The robot has allowed many different surgical specialties to operate in confined areas of the body with tiny instruments placed through equally small incisions thereby avoiding a larger incision. In thoracic surgery, one of the confined spaces is an area in front of the heart where a gland called the thymus resides.

Most people don’t even realize they have a thymus nor do they know it’s responsible for the development of immunity. However, for a small number of patients the thymus can be source of disease either by generating a tumor called a thymoma or by producing antibodies that block transmission of nerve impulses making the patient fatigue or weaken very quickly which is called myasthenia gravis (MG). Removing the thymus gland (thymectomy) is an important part of the treatment in both diseases.

Traditionally, thymectomy is accomplished ...

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