Surgical Procedures

Surgical Procedures

Surgical Procedures

Surgical procedures are done to repair injuries to joints, muscles and bones and to diagnose and treat certain diseases.

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  • 1 Answer
    ADr. Marc M. Zare, MD, Bariatric Medicine, answered on behalf of Good Samaritan Hospital
    What Is a Laparoscopic Sleeve Gastrectomy?
    Laparoscopic sleeve gastrectomy is the most common bariatric procedure. In this video Marc Zare, MD, a bariatric surgeon at Good Samaritan Hospital, explains how much the stomach is reduced in size with this procedure.
  • 1 Answer
    Although postoperative complications after spine surgery are a rare occurrence, experts believe that education and compliance is the key to prevention.

    Blood clots, also known as DVTs, are a potential complication with any surgery. Blood clots can be caused by prolonged bed rest or inactivity. Blood that is moving is less likely to clot, so to prevent blood clots it is important to do the following:
    • Take your anti-coagulant while in the hospital as ordered.
    • Keep the sequential compression devices on your legs while you are lying in bed.
    • Participate in physical therapy.
    The signs and symptoms of a DVT may include the following:
    • pain in the back of your calf that comes and goes
    • a dull ache in the calf when walking
    • a calf that is warm to the touch and reddened
    If you feel you are experiencing any of these symptoms, tell someone in your healthcare team right away.

    Remember to call for assistance prior to attempting to get out of bed. You will still be attached to many things such as your intravenous (IV) line and sequential compression devices (SCDs). You may be taking pain medications that may put you at risk for falling. Avoid bending. If you drop something, call for help as well.
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    Some pain after spine surgery is normal. The nursing staff will assist you in keeping your pain at a tolerable level. You will be asked to use a pain scale to rate your pain with zero being no pain and 10 being the most pain you've ever experienced. This scale assists the nursing staff in knowing how best to manage your pain.

    Some of the pain relief options after surgery may include a patient-controlled analgesic (PCA). This is a button that you push when you experience an increase in your pain. This button delivers a set amount of pain medication through your intravenous (IV) line. The nurse may administer pain medication directly through your IV. You may take oral pain medication.

    The pain scale also assists the nurses in knowing how effective the intervention for your pain has been. If your pain has gone from five to three after receiving pain medication or an intervention, then they know the intervention is working for you. If there is no decrease in your pain, then a different intervention may be needed.
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    On the day of your spine surgery, you should plan to arrive two hours prior to your surgery time. You will be directed to the surgical waiting area. When they are ready for you in the presurgery area, someone will escort you there. In the presurgery area you will change into your hospital gown, go over your consent documentation, review your medical history, including the list of medications you have prepared, have a physical assessment, speak with an anesthesiologist and have an intravenous (IV) line started.

    During your surgery your family may wait for you in the surgical waiting area. After the surgery is complete the surgeon will speak to your family. Time in the recovery room may vary.
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    Prior to your spine surgery your doctor may order one or more of the following tests: blood work, electrocardiogram (EKG), chest x-ray and medical clearance.

    The day before your surgery, you'll be asked not to eat or drink anything after midnight. This means no gum, mints, sips of water or coffee. The only exception is if you have been instructed to take one of your medications the morning of surgery. If this is the case take it with the smallest sip of water possible. You may brush your teeth the morning of surgery.

    Do not put on any make-up, lotions or perfumes on the morning of your surgery.
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    When preparing your home for discharge after spine surgery, make sure any safety modifications are addressed prior to your surgery. This will decrease your risk for falls or injury. Some general household modifications to consider are the following:
    • Move electrical and telephone cords away from walkways.
    • Identify an appropriate sitting surface in all rooms. Use chairs with armrests.
    • Avoid low surface or overstuffed sofas, chairs or recliners.
    • Know the whereabouts of your pet.
    • Remove throw rugs or small area rugs.
    If you have stairs, replace any worn stair treads. If feasible, install stable handrails on both sides of the stairs. Stairs and hallways should be brightly lit. Add night-lights where possible.

    In the bathroom, you may wish to install grab bars in the bathtub. For increased traction, install skid resistant strips in your bathtub or shower pan and a rubber mat in front of the bathtub. Your therapist may recommend a raised toilet seat. Remove any mats or small rugs in front of the sink or the commode.

    In the bedroom have a lamp and a phone within reach of the bed. Keep a clear path from the bedroom to the bathroom. Always sit while getting dressed. Use night-lights wherever possible. Make sure that any bedspreads, duvet covers, blankets, clothing, long drapes and your pet are not in your walking path.

    In the kitchen store frequently used items at waist level and less frequently used items in higher cabinets. Making meals and freezing them beforehand will reduce the time spent on meal preparation. By doing this before the surgery, your meals can be better planned from a nutritional standpoint.
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    When preparing for spine surgery, there are a few general health guidelines that you should follow in the weeks leading up to your procedure:
    • Focus on good nutrition.
    • Take your daily medication as directed by your doctor.
    • Discuss with your doctor any nutritional and/or herbal supplements that you are taking. Some medications may increase your risk of bleeding, and your doctor may direct you to stop those seven to 10 days prior to your surgery.
    • Avoid alcoholic beverages.
    • Stop smoking.
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    Spine surgery is used to treat back pain that does not improve after standard care. In most people, spine surgery is only considered after extended nonsurgical therapy. However, there are some conditions where surgery may be necessary. Your doctor can help you determine when surgery may be an appropriate treatment for your condition.

    Common types of spine surgeries include:
    • Diskectomy: surgery to remove all or part of your disk to help relieve pressure on pinched nerves
    • Laminectomy: surgery to remove the lamina (two small bones that make up a vertebra) to take pressure off your spinal cord or nerves
    • Spinal fusion: the fusing of two bones in your back to correct problems in your spine
    • Vertebroplasty: the injection of bone cement into compressed vertebrae
    • Foraminotomy: surgery to widen the opening in your back where nerve roots leave your spinal column
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    Researchers have used a custom-designed three-dimensional (3D) printer that had been modified by engineers to enable printing of living cells. The printer produces a biodegradable structure (scaffold) that can be combined with living cells to create a tracheal segment. The size and shape of the scaffold can be customized for each person.

    In a study, the researchers made three types of printed segments: empty segments, segments without cells (controls) and segments that had been combined with living cells. The bioprinted cells were tested for viability, proliferation (cell growth and division) and gene expression. The researchers found that the cells survived the printing process, were able to continue dividing, and produced the cellular properties expected in healthy tracheal cartilage.

    The results showed that 3D printing can be combined with tissue engineering to effectively produce a partial tracheal replacement graft in vitro. The data demonstrated that the cartilage cells seeded on the graft retained their biological capability and were able to proliferate at the same rate as native cells.

    3D printing has the potential to revolutionize medicine; people are already seeing benefits from the technology in the area of customized prosthetics for limb replacement. Reconstructive craniofacial and cardiothoracic surgeons also have been using 3D printers to build models for more precise surgical planning.

    The next phase will be integrating 3D printing and tissue engineering to produce customized biological replacement parts. While further development is necessary before a clinical trial would be viable, the results show that 3D printing technology is a feasible alternative to traditional treatments.

    It's important to note that 3D printed tissue is not yet approved by the U.S. Food and Drug Administration (FDA).
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    Three-dimensional (3D) printing can effectively create a biodegradable tracheal segment containing a person’s own cells for use in complex tracheal reconstruction.

    The trachea (windpipe) is a tube that connects the upper respiratory tract to the lungs and helps carry air to the lungs. Traditional treatments for tracheal diseases such as stenosis (narrowing) or malacia (abnormal softening of the tissue) usually involve removal of the affected tracheal segment.

    Three-dimensional printing and tissue engineering has the potential for creation of a custom-designed tracheal replacement prosthesis in the lab so that the affected tracheal segment can be swapped out instead of removed.

    It's important to note, however, that 3D printed tissue is not yet approved by the U.S. Food and Drug Administration (FDA).