A live Webcast originating from the Operating Room of the Future at the University of Maryland Medical Center in Baltimore will show minimally invasive surgery to treat a serious form of heartburn, called gastroesophageal reflux disease (GERD). The Webcast will begin at 5:30 p.m. on Tuesday, May 4, 2004.
During the procedure, a laparoscopic Nissen fundoplication, surgeons will make five small incisions and use a laparoscope (a long, thin instrument that contains a video camera) to repair the lower esophageal sphincter, a muscle that separates the stomach and esophagus. Normally, that muscle closes after a person eats or drinks to keep food and stomach acids from returning up into the esophagus. But in people who experience chronic reflux, the muscle does not stay closed tightly or is unable to close properly, and they have heartburn, chest pain, cough, difficulty swallowing or regurgitation. Left untreated, reflux can lead to serious complications, including esophageal ulcers or bleeding.
“The beauty of this procedure is that we make the repair using the patient’s own anatomy,” says Adrian E. Park, M.D., head of General Surgery at the University of Maryland Medical Center and professor of surgery at the University of Maryland School of Medicine.
“In this procedure, we wrap a part of the stomach known as the gastric fundus around the lower esophagus, which prevents the flow of acid back into the esophagus,” adds Dr. Park, who will perform the surgery during the live Webcast.
J. Scott Roth, M.D., head of surgical endoscopy at the University of Maryland Medical Center and a faculty member of the University of Maryland School of Medicine, will explain the progress of the operation during the live Webcast, and provide background information about the procedure.
For many people, reflux can be treated effectively with medications. Surgical candidates are those whose heartburn is not well controlled with medicine, those who want to fix the problem without having to take medicine long-term, and those who are having complications from reflux, including ulcers or hernias.
This minimally invasive laparoscopic surgical procedure is an alternative to traditional "open" surgery, in which a large incision must be made. A laparoscope is a fiber-optic instrument that transmits images from within the body to a video monitor in the operating room, allowing the surgeons to see the operative area on the screen without the need for a large incision.
The laparoscopic surgery often requires a hospital stay of only 23 hours, instead of nine days required for the traditional, “open” surgery. In many cases, recovery time to get back to normal activities can take less than two weeks with the minimally invasive procedure, compared to about one month with the traditional surgery.
Patients at the University of Maryland Medical Center are counseled before the operation about lifestyle and dietary adjustments that are needed for about six weeks following surgery. They are advised to eat smaller amounts of food at each meal, to chew their food well, and avoid chewing gum and drinking carbonated beverages, to make sure the surgery will heal properly.
The success rate for the minimally invasive surgery is 90 to 95 percent for patients who have the typical symptoms of GERD, such as heartburn, regurgitation, or belching. For those whose with less typical symptoms, including hoarseness and chronic cough, the surgery is about 60 to 80 percent effective at relieving their symptoms.
“Outcome, success and complications during surgery are very closely linked to the experience of surgeons and the volume of cases they do,” says Dr. Park. He adds that equally important is the patient’s commitment to cooperate with certain lifestyle and eating modifications in the immediate weeks after surgery.
The University of Maryland Medical Center opened the nation’s newest, most technologically advanced surgical facility in May 2003. The surgical facility, located in the Medical Center’s new 380,000-square-foot Weinberg Building, houses 19 operating rooms for adult and pediatric patients.
The surgical facility is called the “OR of the Future” because it was designed to accommodate the latest technical innovations and the best patient care practices. The operating rooms combine the most advanced video and other communications equipment with information technology in order to enhance patient safety and operational efficiency. More than 16,000 surgeries are performed at the Medical Center each year.
This surgical Webcast has been approved for AMA PRA credit, which is sponsored by the University of Maryland School of Medicine.
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