Earlier diagnosis
Dr. Kim Heller, a specialist in complicated pregnancies, spoke about a case from the past year. The patient was diagnosed as having placenta accreta, an increasingly common abnormality in which the placenta adheres to the uterus and sometimes grows though it into other organs. The condition can be fatal to the mother at time of delivery, Heller said: although the baby is fine, the mother can bleed to death because the physician may be unable to remove the placenta or the uterus.
In this case “we were able to make the diagnosis at 20 weeks because of our great imagery technology and ultrasound,” Heller said. It helped that she “had seen this condition before and could identify it.”
Knowing the risks, Heller “tried to anticipate everything that could go wrong and have the right resources,” which involved putting together a team comprised of a variety of different specialists, including a surgical gynecologist, urologist, and anesthesiologists. The team made sure the operating room was available at all times and coordinated with a blood bank. The patient underwent an early delivery in the operating room assisted by a large number of people. Interventional radiology was another tool that was employed. Specialist catheters were used to block blood vessels. The delivery was a success, with no bleeding complications.
Dr. James Ryan Nitzkorski, a surgeon specializing in complex cancer, spoke about single incision laparoscopic surgery, a minimally invasive procedure involving a very small incision. The surgery “has very little pain, and patients are often walking around the day of the surgery,” he said. Laparoscopic surgery for colon and ultra-low rectal cancer in most cases preserves the functionality of the organs, thereby enabling the patient to avoid a permanent colostomy, he noted.
He described another advanced technology, trans-anal endoscopic microsurgery, which removes tumors in the bowel without an incision by using the patient’s natural orifice. “The instruments let us sew you up from the inside, and no hospitalization is required,” he said, projecting a photo not for the squeamish.
Such techniques result in radically reduced hospital stays — in the case of colon surgery, an average of four days as opposed to the standard average of nine, according to the data. Many patients go home after just three days. Nitzkorski noted that VBMC is participating in a new clinical trail for rectal cancer involving treatment using chemotherapy alone, without radiology. He also praised the new ambulatory center, which enables patients to be taken care of quickly and go home quickly. “They leave so happy,” he said.
Quipping that he wouldn’t be showing any slides of organs or “genitals, from inside or out,” Dr. Michael Sama talked about emergency services at VBMC and its sister HealthQuest hospitals, Northern Dutchess and Putnam County Hospital. He described a new cardiac program, which consists of software that uses telemetry to allow outside emergency personnel to transmit vital information about a person suffering cardiac arrest to the emergency department prior to arrival. That information cuts down on delays and enables the patient to receive treatment immediately upon arrival.
