Robotic Surgery - Amazon S3€¦ · Robotic surgery is performed through tiny incisions, leading to...

Robotic Surgery: A new option for quicker recovery

Noninvasive cardiac imaging page 7

Repairing a broken heart page 6

Events, classes and support groups page 4

2011SUMMER

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But today, these computer-enhanced marvels are helping to make minimally invasive surgery even less invasive.

Long Beach Memorial recently purchased its second robotic system. “This new acquisition prepares the hospital for the growing number of cancer surgeries performed with this leading- edge technology,” says Judy Fix, R.N., senior vice president of patient care services. “It also makes the MemorialCare Heart and Vascular Institute one the nation’s leading centers for robotic surgery west of the Mississippi.”

IncredIble PrecIsIon Known as the da Vinci® S. Surgical System, the robot is controlled by the surgeon. Operating

the machine from a console a short distance from the patient, the doctor uses a joystick- like handle to move the robot’s arms, wrists and fingers, which are equipped with a miniature video camera and tiny surgical instruments. Each movement of the surgeon’s hands is translated into precise, real-time movements by the robot. And since the robot’s “wrists” have a 270-degree range of motion, surgeons are able to perform micro-manipulations in small, often hard-to-access areas of the body.

Additionally, the robot’s viewing system produces high-definition, 3-D images, allowing the surgeon

to see inside the patient in unprecedented detail. The result is a very precise surgery performed through very small incisions. “The robot represents a significant advance over laparoscopy, a minimally invasive technique that uses rigid instruments and 2-D imaging,” says Fix.

For heart patients, the benefits of robotic surgery are numerous, including the elimination of a 10- to 12-inch chest incision. Instead, thanks to the robot’s manual dexterity and 10-power imaging system, doctors are able to access the heart through a few tiny incisions between the ribs. And there’s more good news: In most cases, there’s no need for a machine to take over the function of the heart and lungs when the robot is used. This

revolutionary approach to surgery results in less pain for the patient, reduced blood loss, minimal scarring, a shorter hospital stay, faster recovery and quicker return to normal daily activities.

AdvAnced HeArt surgery One of the most common

robotic-assisted heart

For years, the only roles robots played were in science fiction thrillers.

Robotic Surgery: A new option for quicker recovery

LO N G B E AC H M E M O R I A L • S U M M E R 2 0 1 1

procedures performed at Long Beach Memorial is mitral valve surgery. When the mitral valve, which controls blood flow to one of the lower chambers in the heart, doesn’t close properly, blood can back up into the lungs. This makes the heart work harder and increases the risk of heart failure. Known as mitral valve prolapse, the condition can be corrected by either repairing the valve with the patient’s own tissue or replacing it with an artificial valve. Both approaches are among the most complex surgeries performed by cardiothoracic surgeons.

Robotic surgery is performed through tiny incisions, leading to quicker recovery and minimal scarring.

Long Beach Memorial cardiothoracic surgeons have also been leaders in the development of robotic beating-heart coronary artery bypass surgery. The operation is performed through three small incisions, while the chest is closed and the heart is beating. The robot also is used to insert pacemakers, correct certain congenital heart defects, remove cardiac tumors, correct the chaotic heart rhythm of atrial fibrillation, and repair atrial septal defects—holes in the wall separating the top two chambers of the heart.

A growIng lIst And the list of robotic procedures continues to grow—not only in the field of cardiothoracic surgery, but in other areas such as cancer surgery. For example, Long Beach Memorial surgeons use the robot to treat cervical, early-stage ovarian and endometrial cancer—all of which typically require a hysterectomy. With conventional surgery, the incision for a hysterectomy extends from the pubic bone to just above the belly button. But a robotic hysterectomy is performed through four or five tiny openings, resulting in a faster return to everyday activities.

Among the many urologic procedures performed robotically is the prostatectomy, or removal of a cancerous prostate gland. Due to its precision, the robotic-assisted prostatectomy significantly surpasses other surgical methods and is particularly notable in the post-surgical restoration of urinary control and preservation of sexual function.

Robotic surgery is also the latest breakthrough in minimally invasive surgery for colorectal cancer. Precision is especially important when operating in the pelvis, which houses blood vessels and nerves that must be preserved to ensure a patient’s quality of life. Patients undergoing robotic surgery for rectal or colon cancer typically resume a normal diet and bowel function faster than patients who have had conventional surgery. They also go home sooner and return to normal activities faster.

MInIMAl scArrIng The robot is also improving the prospects for people who need surgery for head and neck

cancer. This includes cancer of the thyroid, throat, tonsils, larynx (voice box), pharynx and tongue. For many years, traditional open surgery was the standard—an approach that came with the risk of significant scarring or disfigurement. But the robot allows surgeons to access the target anatomy with greater precision through five small incisions—or no incisions at all, in the case of throat cancer.

Lung cancer patients have also experienced the benefits of the robot. Unlike a thoracotomy, the traditional way of accessing the lungs that requires an 8- to 10-inch incision between the ribs, the robotic version of the operation is performed through a few tiny openings.

What type of surgery—open, laparoscopic or robotic—depends on a patient’s particular condition, general health and other factors. For a referral to a Long Beach Memorial physician using this technology, call 1-800-MEMORIAL or visit memorialcare.org/davinci.


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nutritional counseling Mondays and Tuesdays, by appointment only

Do you need guidance with weight-loss

strategies, diabetes management or help with

a special diet? Join Becky Gerl, clinical dietitian

and certified diabetes educator, for a one-on-one

session. Call (562) 933-0524 for an appointment.

Fee required, some insurance accepted.

tai chi chih Thursdays, 4 - 5 p.m.

Chinese exercise for the mind and body.

Call (562) 933-1650 for more information.

Cost: $5 per session or $24 for six-week session.

living with Heart Failure Tuesdays and Thursdays, 1 - 3 p.m.

Patients diagnosed with chronic heart failure

are invited to join these sessions presented by

the MemorialCare Heart and Vascular Institute.

Held in the Cardiac Rehabilitation Gym. Call

Pat Long at (562) 933-3716 for more information

and registration. Free.

“the Inspirations” Fourth Thursday of every month

11:30 a.m. - 12:45 p.m.

A support group for persons living with chronic

lung disease. Held in the Outpatient Pulmonary

Rehabilitation Center Conference Room,

2840 Long Beach Blvd., Suite 210. Facilitated by

Cynthia Hinderberger, R.C.P., at (562) 933-5864.

HIv Pre- and Post-testing We offer free HIV pre- and post-test counseling

services by appointment. Call (562) 933-8590

for more information and location.

Peripheral Arterial disease (PAd) screening The MemorialCare Heart and Vascular Institute

offers a noninvasive PAD screening for $75. Call

(562) 933-3296 to schedule an appointment.

women’s cardiac risk screening The Center for Women’s Cardiac Health and

Research provides comprehensive cardiac risk

screenings for $55. Call (562) 933-2460

to schedule an appointment.

brain Injury support group Third Thursday of every month, 5 - 6 p.m.

Meeting held at the Transitional Rehabilitation

Services house. Support group is open to both

persons with brain injury and their families. To

RSVP, call (562) 933-1680 by the Monday before

the meeting. Free.

stroke…A-trial Fibrillation—Are you at risk for a stroke with A-Fib? Wednesday, June 29, 1:30 - 3:30 p.m.

Long Beach Petroleum Club Terrace Room

Learn about the effects of atrial fibrillation

and the risks for stroke associated with it. Free

cholesterol and glucose screenings available to

those who register early. Call (562) 922-0520.

stroke and depression—learn to cope with your depression Wednesday, Aug 31, 1:30 - 3:30 p.m.


Learn how depression can increase your risk

factors and how you can prevent stroke. Free

cholesterol and glucose screenings available

to those who register early. Call (562) 922-0520.

stroke and stress…Are you at risk with too Much stress? Wednesday, July 27, 1:30 - 3:30 p.m.


Learn how stress can increase your risk factors

and how you can prevent stroke. Free cholesterol

and glucose screenings available to those who

register early. Call (562) 922-0520.

stroke survivors support group First Monday of every month, 4 - 5:30 p.m.

A support group offering education, support

and hope for stroke survivors. Group is lead by

a rehabilitation social worker. To register, call

(562) 933-9034 one week prior to the meeting.

Held in the MemorialCare Rehabilitation Institute

dining room, Memorial West. Free.

Adult bereavement group Wednesdays, 3 - 5 p.m.

Doctors’ Conference Room 2

Thursdays, 6 - 8 p.m.

Radiation/Oncology Conference Room

Support group open to anyone over the age

of 18. No pre-registration required. Facilitated

by Rev. Diann Davisson. Call (562) 933-1450 for

more information.

Amputee support group First Thursday of every month, 11 a.m.

Learn and share with other amputees.

Educational and fun with great peer support!

Contact Ronda Oaks at (562) 420-2330. Free.

Perinatal loss support group Second and fourth Monday of every month, 7 p.m.

This group is open to anyone who has

experienced the loss of a baby from early

pregnancy, miscarriage, stillborn or newborn

death. Held in the Radiology/Oncology

Conference Room. Facilitated by Rev. Sharon

Yagerlener. Call (562) 933-1454 for more

information.

smoking cessation The MemorialCare Todd Cancer Institute

provides ongoing smoking cessation support

and information. One-on-one support may

also be provided pending insurance. Call

(562) 933-0961.

spinal cord Injury support group Second Monday of every month, 5 - 6:30 p.m.

Celebrate successes and share resources. Group is

lead by a rehabilitation social worker. To register,

call (562) 933-9034 one week prior to the meeting.

Held in the MemorialCare Rehabilitation Institute

dining room, Memorial West. Free.

general Adult volunteers We encourage adult men and women from our

community to join hands with us and make a

difference. Call the Volunteer Resources Department

at (562) 933-1624 for more information.

Memorialcare todd cancer Institute “wings” volunteer Program “Wings” volunteers provide support, comfort,

care and gifts for cancer patients and their

families. Orientation and training are provided.

To become part of our team as a TCI “Wings”

volunteer, contact the Community Outreach

Department at (562) 933-0961.

The following classrooms are located inside Long

Beach Memorial, 2801 Atlantic Ave.: Classrooms

1 and 2, Houssels Forum, Radiation/Oncology

Conference Room, Cardiac Rehabilitation Gym,

Human Resources Conference Room, MemorialCare

Center for Women and MemorialCare Rehabilitation

Institute. For directions, visit memorialcare.org

and click on “Locations.” For class information,

visit memorialcare.org/classes.

Parking card Get unlimited parking for a year when you

join the Senior Plus program for $25, renewals

$20. Parking cards can be purchased in the

MemorialCare Rehabilitation Institute lobby

Monday through Thursday from 8:30 a.m. to 4 p.m.


Medicine, Munchies and Movies Saturdays, Sep 24, Oct 15, Nov 19, Dec 10,

Noon

Join us for a monthly informational health

lecture, complimentary lunch and movie. Every

month a new health topic will be highlighted.

Call (562) 933-1650 for more information and

a required reservation.

save a life. donate blood today. At Long Beach Memorial and Miller Children’s

Hospital Long Beach, more than 1,000 units

of blood are used every month in lifesaving

procedures. You can help save the life of

someone right here in your community. Call

(562) 933-0808 to schedule an appointment.

beat the odds in cancer treatment This program offers research-based strategies

for improving quality of life, symptoms and side

effects to achieve positive-impacted survival

after a cancer diagnosis. The program was

developed and is conducted by physicians.


breast cancer Mentors Peer-mentoring group for newly diagnosed

breast cancer patients who will be matched with

breast cancer survivors. Call (562) 933-7815 for

more information.

cancer Answers Monday through Friday, 8:30 a.m. - 5 p.m.

This cancer helpline is designated to meet the

needs of cancer patients and their families.

An experienced oncology nurse responds to

your questions about treatment options and

cancer resources. Call (562) 933-0900 for more

information.

cancer Patient and Family support group Wednesdays, 6 p.m.

Sponsored by The Wellness Community. Call

(310) 376-3550 for more information. Meets in

MemorialCare Rehabilitation Institute. Free.

Kids, tweens and teens Monthly, 5 - 6:30 p.m.

A free support group for children whose parent

or significant person in their lives has been

diagnosed with cancer. The group meets once

a month and participants are broken into three

different age groups. Call (562) 933-0900 for

more information.

look good…Feel better at long beach Memorial Sponsored by the American Cancer Society,

the Look Good…Feel Better program provides

workshops for women undergoing cancer

treatment. Participants receive instruction on

makeup application and skin care provided by

trained volunteers and licensed cosmetologists.


newly diagnosed breast cancer support group Wednesdays, 4:30 - 6 p.m.

Held in the Radiation/Oncology Conference

Room. Call (562) 933-7845 for more information.

ovarian and gynecological cancer support group First and third Tuesdays of each month, 4:30 - 6 p.m.

A support group for women with ovarian and

gynecological cancers. Call (562) 933-0900 for

more information.

Prostate cancer support group Fourth Tuesday of every month, 6:30 - 8 p.m.

Sponsored by US TOO. Call (562) 933-0900 for

more information.

women guiding women A peer-mentoring program for newly diagnosed

gynecologic cancer patients who will be

matched with a trained gynecological cancer

survivor. Call (562) 933-7815.

Adult Insulin-Pump support group Second Monday of every month, 6:30 - 8 p.m.

Support group for adults with diabetes who are

using insulin pumps. Facilitated by Linda Kerr,

R.N., C.D.E., (562) 933-5070. Significant others are

welcome. Held in fifth floor classroom. Free.

living with Arthritis Second Wednesday of every month, 10 - 11 a.m.

Learn what you can do to manage your arthritis

and all about the available treatment options.

Held at Long Beach Memorial in the Human

Resources Classroom (ground floor). Call

(562) 933-9090 to register.

team spirit breast and ovarian

cancer 10K walk

Saturday, Sep 24

Check-in opens at 6:30 a.m.

Walk begins at 8 a.m.

Help win the fight against breast and

ovarian cancer by participating in the 2011

Team Spirit Breast and Ovarian Cancer 10K

Walk on Saturday, September 24 starting at

8 a.m. To be a part of Team Spirit, register

online at teamspiritonline.org or call

(562) 896-4037. For sponsorship, contact

Michele Roeder at (562) 933-1671.

sPecIAl events

screenIngs

stroKe volunteer oPPortunItIes

exercIse

HeArt

dIAbetes

Even

ts & C

lasse

s

4

suPPort grouPs

lung

southern california Patient & Family centered care

conference

Friday, June 24, 8 a.m. - 4 p.m.

This conference has been planned to

provide a local opportunity for hospital

staff, administrators, as well as patients

and family members to come together in

interdisciplinary teams to learn, develop

and share skills in Patient & Family Centered

Care (PFCC). Community members and

families with hospitalization experience are

encouraged to attend for a discounted rate.

For more information, visit pfccpartners.com.

educAtIon

5

cAncer cAre

Are you or someone you know experiencing

foot drop as a result of a stroke and are

the age of 18 or older? If you meet the

requirements for participation, you may

able to participate in a research study at

Long Beach Memorial. For more information,

please contact Wendy Lazouras, DPT at

(562) 933-9032.


6

Today, the Los Osos resident continues to accrue frequent flier miles commuting to Europe and Asia. But when he learned he had a potentially serious heart condition, Jerald sought help closer to home.

The 62-year-old’s medical odyssey began in 2010 when he was found to have a leaky mitral valve. The valve, located between the heart’s upper left chamber (atrium) and lower left chamber (ventricle) is composed of two flaps called leaflets. The flaps are designed to close tightly when the ventricle contracts. This prevents blood from flowing back into the atrium. If the leaflets don’t seal completely—a condition called prolapse—blood may leak into the atrium and up to the lungs. “Most prolapsed valves don’t need treatment,” explains

Daniel Bethencourt, M.D., a renowned cardiothoracic surgeon and director of cardiac surgery at Long Beach Memorial. “But if a person has a severe leak or symptoms such as shortness of breath, the damaged valve may need to be surgically replaced or repaired.”

A new oPtIon Until recently, the only option for people with mitral valve disease was open heart

surgery. This requires a 10- to 12-inch incision in the chest, splitting

the breastbone, and spreading the ribs to

access the heart. Recovery from the procedure is slow—as much as three months or more. The return to normal

activities may take even longer.

Robotic surgery is a state-of-

the-art option for mitral valve prolapse.

“I wasn’t ready to be sliced open,” Jerald explains. “I’m very active; I do yoga and

Pilates and compete in martial arts here and abroad. I travel constantly. I didn’t want to be sidelined for weeks or months.”

robotIc exPertIse On his cardiologist’s recommendation, Jerald investigated two major medical centers offering robotic surgery. Then he did some due diligence of his own. “That’s when I learned about Long Beach Memorial and the Bethencourt Group,” he says. “I immediately knew that’s where I wanted to be.”

Tests at Long Beach Memorial showed that Jerald had damage to the leaflets, which prevented them from closing properly. He also had ruptured cordae tendineae—bands of tissue that connect the mitral valve to tiny muscles in the heart. Signals sent from these muscles to the cordae tendineae cause the mitral valve to open and close. “Think of the mitral valve as a tiny parachute,” Dr. Bethencourt says. “The cordae are like the parachute’s guide wires. In this case, both the parachute and guide wires were broken.”

unPArAlleled AccurAcy Fortunately, Jerald was an ideal candidate for robotic surgery. “The surgeon is in control of the robot at all times, but the machine’s wrists and fingers are more flexible and precise than human hands,” Dr. Bethencourt says. “Robot-assisted surgery allows doctors to view the heart in exceptional detail and to operate with unparalleled accuracy through very small incisions.” The benefits for patients are significant: less blood loss, a shorter hospital stay, faster recovery, and greatly reduced pain and scarring.

Jerald was in the hospital just 48 hours. The day of his release, he drove from Santa Barbara to Los Osos—a trip that would have been unthinkable after open heart surgery. And he’s been to the gym and Pilates class every day since.

“I couldn’t be happier,” he says. “I have no ill effects whatsoever. And the treatment I received from the care team at Long Beach Memorial and the Bethencourt Group was superb. If you told me I had to pay a million dollars for my surgery, this is still the place I would choose.”

For a referral to a Long Beach Memorial cardiologist, call 1-800-MEMORIAL or visit memorialcare.org/doctors.

During his 31 years directing Japanese commercials, Jerald Downen lived and worked all over the world.

Robotic Surgery Repairing a broken heart


7

And just like any other engine, it needs proper maintenance and care to work efficiently and remain in good condition.

MemorialCare Heart and Vascular Institute (MHVI) at Long Beach Memorial is ranked in the top 1 percent of California’s 600 hospitals for cardiovascular care. As national leaders in advanced, noninvasive cardiac imaging technology, MHVI heart specialists evaluate thousands of patients each year to determine their risk of heart disease and provide preventive strategies. “An ounce of prevention is worth a pound of cure,” says Gabe Vorobiof, M.D., MHVI medical director of noninvasive cardiology and cardiac imaging. “Early screening can identify potential problems soon enough so patients can benefit from effective preventive care.”

The leading cause of death in the U.S., heart disease is generally referred to as a “silent killer” because a heart attack is often the

first symptom a patient experiences. MHVI offers a range of diagnostic tests that can determine the type and extent of heart disease present. The choice of which tests to perform depends on a patient’s risk factors, history of heart problems and current symptoms.

testIng tHe HeArt Among the noninvasive tests that focus on early screening and prevention is the coronary calcium score. This five-minute exam is performed on a computed tomography (CT) scanner and can show the presence, location and extent of calcium deposits on the inner walls of the coronary arteries—a signal of heart disease.

A carotid intima-media thickness (CIMT) ultrasound

uses high-frequency sound waves to capture images of the movement and speed of blood through the carotid arteries—the large arteries on either side of the neck— as well as the amount of plaque buildup. “The carotid arteries provide us with a window into the condition of the coronary arteries, which is very useful in predicting future cardiovascular risk,” says Dr. Vorobiof.

Echocardiography uses sound waves to monitor the heart’s pumping capacity and synchronization. When used in conjunction with an exercise stress test, it can identify blood flow blockages caused by coronary

artery disease. And in a computed tomography coronary angiogram (CTA), a contrast dye is used to detect areas of arterial narrowing in the coronary arteries in a completely non-invasive fashion.

For patients with known or suspected heart disease, advanced imaging can be used to conduct further evaluations. Cardiac MRI, which produces three-dimensional views of the heart muscle and arteries, is especially helpful for assessing areas damaged by a heart attack. A 3-D echocardiogram can provide dynamic, detailed images that can help determine the condition of the heart’s valves, among other things. And positron emission tomography (PET) can measure blood flow in the heart and identify viable areas that have been damaged by a heart attack but are still capable of recovery. When combined with CT, PET can provide a comprehensive look at the structure and function of the cardiovascular system.

eArly dIAgnosIs Key Depending on a patient’s diagnosis, treatment strategies may include lifestyle modifications and medication such as cholesterol-lowering medications. If significant heart disease is found, more invasive therapies may be necessary such as angioplasty or surgery.

Early diagnosis and treatment of heart disease have proven to be effective. In the past decade alone, the death rate from heart disease has declined by more than 25 percent. “Our focus will remain on providing patients with the most innovative cardiac care available—and identifying heart disease early, when it’s most easily treated,” he says.

For referral to a Long Beach Memorial cardiologist, call 1-800-MEMORIAL or visit memorialcare.org/doctors.

Weighing less than a pound and averaging the size of a clenched fist, the heart is the engine of the human body.

Noninvasive Cardiac Imaging Getting to the heart of the matter

Gabriel Vorobiof, M.D., is medical

director of noninvasive cardiology,

heart failure and cardiac imaging

at the MemorialCare Heart and

Vascular Institute.

NON-PROFIT ORG.

U.S. POSTAGEPAID

PERMIT NO. 394LONG BEACH, CA

Long Beach Memorial is a not-for-profit, community-based hospital. It is part of

MemorialCare, which also includes Miller Children’s Hospital Long Beach, Orange

Coast Memorial and Saddleback Memorial in Laguna Hills and San Clemente.

1-800-MEMORIAL • memorialcare.org

2801 Atlantic Avenue • Long Beach, CA 90806

Help win the fight against breast and ovarian cancer by participating in the 2011 Team Spirit Breast and Ovarian Cancer 10K Walk on Saturday, September 24 starting at 8 a.m. Team Spirit brings friends and families together to raise money for breast and ovarian cancer research, diagnosis and treatment at Long Beach Memorial. Team Spirit was founded in 2000 as a small grassroots organization on the belief that more can be done to help fight and raise awareness of breast and ovarian cancer in the community.

The 2010 Team Spirit Walk raised $210,000— putting the total amount raised since 2000 to more than $1 million dollars. Be a part of Team Spirit. Register online at teamspiritonline.org or call (562) 896-4037. For sponsorship, contact Michele Roeder at (562) 933-1671.

Be a Part of Team Spirit

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Team Spirit participants celebrate their fundraising efforts

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Long Beach Memorial Named Best Regional Hospital

Named one of “America’s Best Regional Hospitals” by U.S. News and World Report,

Long Beach Memorial has been recognized for excellence in the following specialties:

cancer; heart and heart surgery; gynecology; orthopedics; neurology and neurosurgery;

gastroenterology; geriatrics; diabetes and endocrinology; ear, nose and throat; kidney

disorders; pulmonology; and urology.

2010-2011

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LOS ANGELES, CA

Robotic Surgery - Amazon S3€¦ · Robotic surgery is performed through tiny incisions, leading to...

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