Ralph Aye
Ralph W. Aye, M.D.

Ralph W. Aye, M.D.

Ralph W. Aye, 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, VISA, Master Card, Cash, Check, American Express, Discover Card, Money Order

Insurance Accepted:

Contact this office for accepted insurance plans.

Additional Information:

Appointments

Clinical Program Leader, Thoracic Oncology - Swedish Medical Center

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

Fellowship Director, Advanced Minimally Invasive Thoracic/Foregut Surgery - Swedish Medical Center

Clinical Instructor, General Surgery Residency Program - Swedish Medical Center
Medical Editorial Board - NexCura


Videos

Lung Cancer ScreeningLung Cancer Screening

Introduction to Esophageal Surgery Part 1

Introduction to Esophageal Surgery Part 2

 


Professional Highlights

KCPQ TV Airs Story on Lung Cancer Awareness Featuring Dr. Aye

"I think part of the problem is we usually associate it with smoking." Dr. Aye says. "And yet, more than half of lung cancer today is being discovered in non smokers or former smokers"

"If there are some early symptoms, if someone is a smoker, ask your physician for a chest x-ray. it's politically incorrect for me to say that because chest xrays for screening are not recommended, but I think it's up to the individual to be an advocate for themselves..."  Read the transcript

News Release
Swedish Lung Cancer Screening

 

Dr. Aye 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

Dr. Aye was voted "Top Doctors" in Seattle Magazine (2009, 2010, 2011, 2012, 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

Philosophy of Care

I offer compassionate, effective and appropriate care. I cure when possible -- listen and comfort always.

Personal Interests

Family; music - voice and guitar, jazz, classical; the outdoors; sailing

Medical School

University of Pittsburgh, PA

Residency

New York University; Swedish Medical Center, WA

Fellowship(s)

Frenchay Hospital (Thoracic Surgery), United Kingdom; Howard S. Wright Fellow (Thoraco-Esophageal Surgery), Washington

Board Certifications

American Board of Surgery - General Surgery (Re-certified in 1995 and 2005)

Additional Information:

Appointments

Clinical Program Leader, Thoracic Oncology - Swedish Medical Center

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

Fellowship Director, Advanced Minimally Invasive Thoracic/Foregut Surgery - Swedish Medical Center

Clinical Instructor, General Surgery Residency Program - Swedish Medical Center
Medical Editorial Board - NexCura


Videos

Lung Cancer ScreeningLung Cancer Screening

Introduction to Esophageal Surgery Part 1

Introduction to Esophageal Surgery Part 2

 


Professional Highlights

KCPQ TV Airs Story on Lung Cancer Awareness Featuring Dr. Aye

"I think part of the problem is we usually associate it with smoking." Dr. Aye says. "And yet, more than half of lung cancer today is being discovered in non smokers or former smokers"

"If there are some early symptoms, if someone is a smoker, ask your physician for a chest x-ray. it's politically incorrect for me to say that because chest xrays for screening are not recommended, but I think it's up to the individual to be an advocate for themselves..."  Read the transcript

News Release
Swedish Lung Cancer Screening

 

Dr. Aye 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

Dr. Aye was voted "Top Doctors" in Seattle Magazine (2009, 2010, 2011, 2012, 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

The Hill Antireflux Repair at 5 Institutions over 25 Years

Aye RW, Rehse D, Kraemer S, Hill L

"In 1181 patients undergoing open Hill repair with median follow up of 9.98 years: 93% of patients had good or excellent results ... Open Hill repair was successfully performed by surgeons not trained by Hill"

View selected presentation slides

Presented at the North Pacific Surgical Association, Seattle, WA November, 2008.

The Nissen-Hill Hybrid: Pilot Study of a New Anti-reflux Procedure

Buduhan G, Louie EB, Orlina J, Daniel S, Rees J, Valliéres E, Aye RW

 

"Laparoscopic Nissen-Hill Hybrid repair is safe and technically feasible. Preliminary results in complicated GERD: excellent control of acid reflux ... high patient satisfaction."

View selected presentation slides

The International Society for Diseases of the Esophagus, Budapest, Hungary, September, 2008

Preliminary Experience with Minimally Invasive Thymectomy

Youssef S, Blitz M, Vallières E, Aye RW, Louie BE

" Minimally Invasive Thymectomy has been successfully adopted at Swedish Medical Center; Compares favorably to traditional resection methods; Utility of neck incision in robotic thymectomy is being investigated; ..."

View selected presentation slides

Washington Chapter of the American College of Surgeons. Lake Chelan, WA. June 14, 2009

 

Principle Investigator, Lung Cancer Screening- I-ELCAP Investigators

Survival of Patients with Stage I Lung Cancer Detected on CT Screening

New England Journal of Medicine, 355:1763-71, 2006

Full Text of This Article

PUBLICATIONS & PRESENTATIONS
Book Chapters:

Aye RW, Hill LD, Kraemer SJM. Shackelford’s Surgery of the Alimentary Tract. Orringer, M, Heitmiller R (editors). The Hill Repair. 5th ed Volume I. W.B. Saunders Company, 2002

Aye RW. Current Therapy in Thoracic and Cardiovascular Surgery. The Hill Procedure for Gastroesophageal Reflux. 1st ed. Harcourt Health Sciences, 2001

Aye RW, Marcus DR, Hill LD. Laparoscopic Repair of Hiatal Hernia and Gastroesophageal Reflux. Soderstrom R (editor). In Operative Laparoscopy,- The Masters' Techniques. 2nd ed. Lippincott-Raven Press: New York, 1998

Hill LD, Mazza DE, Aye RW. The Hill Repair. In operative Techniques in Cardiac & Thoracic Surgery. W.B. Saunders Company 2(1):16-36, 1997

Kraemer SJ, Aye RW, Hill LD. The Hill Repair: A definitive Antireflux Procedure. In Surgery of the Esophagus, Stomach, and Small Intestine. 5th ed. Wastell C, Nyhus L, Donahue P, (editors). Little, Brown, and Company:New York, 1995

 

Publications:
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.
 
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.
 
Mattar SG, Alseidi AA, Jones DB, Jeyarajah DR, Swanstrom LL, Aye RW, Wexner SD, Martinez JM, Ross SB, Awad MM, Franklin ME, Arregui ME, Schirmer BD, Minter RM. General surgery residency inadequately prepares trainees for fellowship: results of a survey of fellowship program directors.  Ann Surg. 2013 Sep;258(3):440-9.
 
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.
 
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; discussion 957-8.
 
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.
 
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; discussion 1057-9.
 
Louie BE, Farivar AS, Aye RW, Vallières E.  Early experience with robotic lung resection results in similar operative outcomes and morbidity when compared with matched video-assisted thoracoscopic surgery cases.  Ann Thorac Surg. 2012 May;93(5)
 
Farivar AS, Louie BE, Aye RW, Horton MP, Vallières E. Extrapleural pneumonectomy for primary pleural mullerian tumor in a young woman. Ann Thorac Surg. 2012 Jan;93(1)
 
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. Ann Thorac Surg. 2011 Jul;92(1):278-82
 
Beatty JD, Adachi M, Bonham C, Atwood M, Potts MS, Hafterson JL, Aye RW. Utilization of cancer registry data for monitoring quality of care. Am J Surg. 2011 May;201(5):645-9.
 
Aye RW, Rehse D, Blitz M, Kraemer SJ, Hill LD.  The Hill antireflux repair at 5 institutions over 25 years. Am J Surg. 2011 May;201(5):599-604.
 
Louie BE, Blitz M, Farivar AS, Orlina J, Aye RW. Repair of symptomatic giant paraesophageal hernias in elderly (>70 years) patients results in improved quality of life. J Gastrointest Surg. 2011 Mar;15(3):389-96.
 
Youssef SJ, Louie BE, Farivar AS, Blitz M, Aye RW, Vallières E. Comparison of open and minimally invasive thymectomies at a single institution. Am J Surg. 2010 May;199(5):589-93.

Buduhan G, Orlina J, Louie B, Vallieres E, Aye R. Endoscopic and manometric position-related characteristics of the normal gastroesophageal junction; Surg Endosc Online, Feb 2010

I-ELCAP Investigators. Survival of Patients with Stage I Lung Cancer Detected on CT Screening. New England Journal of Medicine. 355:1763-71, 2006

Tseng D, Rizvi AZ, Fennerty B, et. al. Forty-Eight-Hour pH Monitoring Increases Sensitivity in Detecting Abnormal Esophageal Acid Exposure. Journal of Gastrointestinal Surgery. 9(8): 1043-1058, 2005

Jobe BA, Kahrilas PJ, Vernon AH, Sandone C, Gopal DV, Swanstrom LL, Aye RW, Hill LD, Hunter JG. Endoscopic Appraisal of the Gastroesophageal Valve After Antireflux Surgery. The American Journal of Gastroenterology. 99(2):233-43, Feb 2004

Jobe BA, Aye RW, Deveney CW et al. Laparoscopic Management of Giant Type III Hiatal Hernia and Short Esophagus: Objective Follow-up at Three Years. Journal of Gastrointestinal Surgery. 6:181-188, March 2002

Rehse DH, Aye RW, Florence MG. Respiratory Failure following Talc Pleurodesis. The American Journal of Surgery, 177:437-440, May 1999

Aye RW, Mazza DE, Hill LD. Laparoscopic Hill Repair in Patients with Abnormal Motility. The American Journal of Surgery, 173:379-382, May 1997

Hill LD, Kraemer, SJ, Aye RW, Mercer D, Low D, Pope CE. The Gastroesophageal Flap Valve: In Vitro and in Vivo Observations. Gastrointestinal Endoscopy 44(5):541-47, 1996

Aye RW, Hill LD, Kraemer SJ, Snopkowski P. Early Results with the Laparoscopic Hill Repair. The American Journal of Surgery, 167:542-546, May 1994

Videos:

Aye RW. Mediastinal Node Dissection for N2 Positive Lung Cancer. Presented at the ACS Thoracic Film Session, October 14, 1999, San Francisco, CA. Accepted for inclusion in the ACS film Library

Aye RW, Hill LD, Larrain A, Kraemer SJ, Mazza DE. The Laparoscopic Hill Repair. Presented at the ACS General Surgery Motion Picture Session, October 8, 1996, San Francisco, CA. Accepted for inclusion in the ACS film Library

Hill LD, Kraemer SJ, Kozarek RA, Aye RW. The Laparoscopic Hill Repair: A Definitive Laparoscopic Antireflux Procedure. Video for the ASGE, San Francisco, CA. May 12-13, 1992

Hill LD, Kozarek R, Pope C, Mercer D, Thor K, Aye RW. The Gastroesophageal Valve - A New Look. September 1989. Clinical Congress of the American College of Surgeons. October 1989

 

Presentations:

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.

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.

Aye RW, Rehse D, Kraemer S, Hill L. The Hill Antireflux Repair at 5 Institutions over 25 Years. The North Pacific Surgical Association, Seattle, WA. November 14, 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 G, 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.

 

Surgical treatment options for GERD

Gastroesophageal reflux disease (GERD) is the most common disorder of the upper gastrointestinal track.  It's estimated that up to 40% of Americans take some form of anti-acid medication at least once a month, making it one of the most commonly used types of medication in the world. 

Heartburn is simply a burning sensation behind the breast bone, and is not necessarily from GERD.  It can be caused by a variety of other disorders, including heart disease, musculoskeletal disorders, and disorders of other parts of the gastrointestinal track, including the stomach, pancreas, gall bladder, liver, or intestine A simple way to differentiate GERD from heartburn is to take antacids or over the counter acid suppressants.  There are two classes of acid suppressants: H2 blockers like ranitidine/zantac; and proton pump inhibitors (PPIs) like prilosec/omeprazole.  If the symptom partially or completely responds, it is likely caused by stomach acid, particularly GERD.

How is GERD managed?

GERD is rarely life-threatening and can generally be managed symptomatically.  Some may ...

Lung Cancer Screening

We screen for breast cancer with mammography, colon cancer with colonoscopy, and prostate cancer with blood tests and exams – why not lung cancer?

If you’re a smoker or a former smoker, or even if you’ve had significant second-hand smoke exposure, you’ve probably worried about your chances of getting lung cancer, and whether there is anything you can do about it. Perhaps you even asked your doctor about getting an x-ray; he or she may have told you that there is no proof that it helps. That’s because a national study done years ago showed no benefit from getting chest X-rays, and therefore it’s not recommended.

The studies

However, since 2000, Swedish has participated in an international study – the International Early Lung Cancer Action Project (I-ELCAP) - to see whether CT scans or CAT scans – very highly detailed X-rays – might be able to find lung cancer earlier and improve cure rates. The study was begun by a group of investigators from Cornell University in New York. They knew that CT scans were very sensitive and would probably show a lot of abnormalities, and that most of them wouldn’t be cancer, so they worked out a system to determine which abnormalities were likely to be cancer. Their system worked, and they showed that when lung cancer was discovered through their screening system the cure rate was over 80%. That’s remarkable, because the normal cure rate for lung cancer is only 15%.

Because of their success, the National Cancer Institute (NCI) began a randomized study with over 50,000 participants. Half of them got annual CT scans and the other half got only chest X-rays. The results were just completed and were very exciting. The group that got CT scans had 20% fewer deaths from lung cancer than the other group!

The results are still being analyzed and there are concerns about safety from too many interventions, radiation exposure, and cost. It will take time to work through these issues, and there is still no general endorsement of lung cancer screening. However, several national organizations now cautiously support screening in high risk groups that meet the criteria for the national study.

Who should get screened, and how?

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Offices

Swedish Thoracic Surgery / First Hill
1101 Madison Street
Suite 900
Seattle, WA 98104
Phone: 206-215-6800
Fax: 206-215-6801

Map & Directions

Swedish Thoracic Surgery / Issaquah
751 NE Blakely Drive
Suite 3020
Issaquah, WA 98029
Phone: 206-215-6800
Fax: 206-215-6801

Map & Directions

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