The Surgeon

After his first weight-loss surgery three years ago, Paul Martin considered getting a tattoo designed around the four small surgical scars on his side—say, a golf green.

After a second weight-loss surgery in December, Martin didn’t have any new scars to add to the design. “I woke up with just a slight sore throat,” he says about the procedure, which took about two hours. “There wasn’t any pain because there weren’t any incisions.”

Martin, 53 years old, is among the first patients at Stanford Hospital & Clinics to be treated using what is called natural orifice surgery. In his case, the entire surgery was performed through his throat.

“We went down his throat with a device that looks like a regular endoscope, with a ‘duckbill’ on the end,” the surgeon, John Morton, MD, said. “In the duckbill is a tiny instrument like a sewing machine, with a needle that has plastic sutures.”

Morton, who is also associate professor of surgery, stitched pleats in the stoma, the opening between the patient’s intestine and the small pouch that had been created in the earlier surgery. He then tightened the pleats around the endoscope, reducing the stoma from 20 millimeters to 14, helping to control the amount of food Martin could digest.
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Conjoined twins Alex and Angel Mendoza from Phoenix, Ariz. were successfully separated after more than 12 hours in surgery, reports Dr. Debbye Turner Bell.

The middle school years can be tough. It’s a time of change and sometimes a little awkwardness. So imagine going through those years with a condition that causes your hands or arm pits to sweat so badly that you avoid social situations. It’s called hyperhidrosis, and doctors at Mayo Clinic say a minimally invasive outpatient surgery can stop the sweating.

Every year, thousands of babies are born with spina bifida. It’s a birth defect where the spinal column does not close properly, exposing nerves to the environment. Most babies born with spina bifida in the United States have surgery soon after birth. But some children in other countries aren’t so lucky. A little boy from Algeria suffered terribly for more than two years until his community helped raise money to send him to Mayo Clinic.

Scientists from the University of Alcalá (UAH) have designed a prosthesis made of silicon and polypropylene shaped like an “upside down T” that substantially reduces cases of incisional hernias.

A hernia is produced when the content of the abdominal cavity protrudes through a weakened natural orifice of the abdominal wall such as the inguinal canal, the umbilical area, the epigastrium or a previous incision in the abdomen such as from a surgical operation. The hernia manifests itself as a bulging lump since the internal lining of the abdomen protrudes in what is called a hernial sac that shrinks or grows depending on the effort exerted by the affected individual.
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Although fewer of them undergo surgery, lung cancer patients in their 80s fare equally well following surgery as their younger counterparts, researchers report. The findings offer doctors potentially valuable guidance in treatment options for elderly patients, according to researchers.

A research team from the Hoag Cancer Center in Newport Beach, California, observed 1,293 patients with lung cancer, 482 of whom underwent surgical treatment. The oldest patients were more likely to be male. Older patients were also more likely to have localized disease.
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The removal through endoscopy of tumours that affect only the superficial layers of the oesophagus can avoid complete extirpation of this part of the digestive tract. The technique, carried out at the University Hospital of Navarra for the last three years, was presented at the VI International Course on Therapeutic Endoscopy in the Digestive System, organized by the Digestive System Service at this hospital. Specifically, more than 90% of patients treated for this ailment at the University Hospital of Navarra have not needed the extirpation of the oesophagus.
400 specialists from ten different countries attended the course, focusing on the therapeutic possibilities of endoscopy in the digestive system. Treatment using digestive endoscopy, without having to carry out surgery, is increasing. These applications are less aggressive than surgical operations and are undertaken at out-patient clinics in about 99% of the cases, which usually enables the patient to go home after the walk-in/walk-out treatment, explained Doctor Miguel Ángel Muñoz Navas, Director of the Digestive System Service at the University Hospital of Navarra.
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Heart surgeons at Washington University School of Medicine in St. Louis report that by adding a simple 10-20 second step to an operative procedure they achieved a significant improvement in the outcome for the surgical treatment of atrial fibrillation (AF).
Reporting in the April issue of the Journal of Thoracic and Cardiovascular Surgery, the surgeons describe an enhancement to the Cox-Maze procedure, a surgical procedure that redirects wayward electrical impulses causing AF by creating precisely placed scars, or ablations, in the heart muscle. The Cox-Maze procedure is highly effective, offering the best long-term cure rate for persistent atrial fibrillation.
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A review of research examining the effectiveness of different obesity treatments has concluded that no matter what other forms of therapy are offered, changes in lifestyle are imperative if patients want to maximise and maintain their weight loss. This review, presented at the annual Society for Endocrinology BES meeting in Harrogate, shows that lifestyle interventions provide benefits at all stages of obesity management and should be encouraged no matter what other forms of therapy are offered.

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