Medical Advances

Emory Hospital First in Atlanta to Earn Comprehensive Stroke Center Certification

Joint Commission Stroke Center Certification

Congratulations to Emory University Hospital who recently joined an elite group of fewer than 30 centers nationwide with its Comprehensive Stroke Center Certification from The Joint Commission and the American Heart Association/American Stroke Association! Emory University Hospital is the only hospital in metropolitan Atlanta to earn this designation and just one of two in Georgia. Comprehensive Stroke Center Certification recognizes only those hospitals that have state-of-the-art infrastructure, staff and training to receive and treat patients with the most complex strokes. Emory University Hospital underwent a rigorous onsite review by The Joint Commission in February 2013.

So, what does this all mean for you? It means that our Emory University Hospital stroke team provides advanced care, including:

  • A state-of-the-art neurointensive care unit, created especially for critically ill stroke patients
  • Neurosurgical interventions for complex conditions that can arise in stroke patients
  • Advanced imaging capabilities
  • Fellowship-trained neurointensivists available 24/7, ready to perform vascular procedures if needed
  • Access to a multidisciplinary team of specialists, including board-certified fellowship-trained stroke neurologists, world-renowned vascular neurosurgeons, highly skilled and experienced interventional neuroradiologists, a board-Certified and fellowship trained neurocritical care team and diagnostic neuroradiologists
  • Thirty-four neurocritical-care unit beds, six neuro step-down or intermediate-care beds and 41 acute-care floor beds

Emory Stroke Center CertificationThe Emory Stroke Center team provides 24/7 coverage and receives early warning about a patient arriving with stroke symptoms. This early notification ensures rapid assessment and stabilization, and an immediate CT brain scan to establish onset time and to determine eligibility for various treatment options.

Stroke is a disease that affects the arteries leading to and within the brain. According to the American Stroke Association, stroke is the number four cause of death and a leading cause of disability in the United States. Immediate treatment is essential when someone is having a stroke to reduce the effects and potential for permanent disability. Not close to Emory when an emergency strikes? Nearly half of our patients are transferred from other hospitals, and most of those arrive via helicopter. The Emory Healthcare system also has three Primary Stroke Centers accredited by The Joint Commission, including Emory University Hospital Midtown, Emory Johns Creek Hospital and Saint Joseph’s Hospital.

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Robotic Surgery – Emory Johns Creek, Making Big Strides with Tiny Instruments

Last year, Emory Johns Creek Hospital purchased a da Vinci® Surgical System and took robotic-assisted surgery at the hospital to a whole new level. The da Vinci® SI, or Streamlined Integrated, is the most technologically advanced system available on the market. It allows surgeons to use tiny robotic instruments they control in real-time to perform minimally invasive procedures requiring only small incisions.

Amy Fischer, Director of Surgical Services for the hospital, says robotic surgery offers patients “a much quicker recovery with virtually no scarring.” It can also simplify more complex surgeries. “Patients who would normally be down and out for six weeks are up and going in a matter of two to three weeks,” says Fischer. “They use less pain medication, and there’s less risk of infection.”

Gynecological surgeons were the first to use the system, to perform hysterectomies and remove fibroids with less pain and blood loss and, in many cases, preserving fertility.

“We hit the ground running and have really just soared with the program,” Fischer says. “In a matter of a year we have grown to offering not just GYN surgery, but general surgery, GYN-Oncology, colorectal and bariatrics.”

Bariatric surgeons are now also using robotic technology to perform gastric bypass and sleeve gastrectomy for weight loss, and Emory Johns Creek Hospital was only the second in the Atlanta area to perform Single-SiteTM gallbladder surgery, a procedure that is now used nationwide. Using Single-SiteTM technology, a cholecystectomy can be performed in about one hour, with a typical hospital stay of less than 24 hours. Thanks to its success with the procedure, the hospital will soon be a case observation site.

Over the past year, more than 300 patients have benefited from the da Vinci® Surgical System. “We have a phenomenal team that has grown with the program,” Fischer says. “And we have had excellent patient outcomes.”

For more information about Emory Johns Creek Hospital and the DaVinci technology visit our website today.

First Single-Site Gallbladder Surgery at EJCH

A surgical team at Emory Johns Creek Hospital performed their first single-site gallbladder surgery on Friday, April 27, 2012. During this minimally invasive laparoscopic procedure, the patient’s gallbladder was removed via a single small incision in the belly button. The team removed the gallbladder using Single-Site™ instruments on a da Vinci® System. This robotic surgical system, which is widely used in complex minimally invasive surgery, allowed the surgeons to remove the gallbladder through an incision of approximately one inch. Traditional robotic surgeries require three to five small incisions.

Potential benefits of Single-Site gallbladder surgery include virtually scarless results, minimal pain, low blood loss, fast recovery, a short hospital stay and high patient satisfaction. The surgery can be performed in about one hour, with a typical hospital stay of less than 24 hours.

During the procedure, the surgeon sits at a console, viewing a 3D, high-definition image of the patient’s anatomy, and uses controls below the viewer to move the da Vinci Robot’s arms and camera. The system translates the surgeon’s hand, wrist, and finger movements in real-time into the more precise movements of the tiny instruments inside the patient. Most people who require gallbladder removal are candidates for the robotic, single-incision surgery.

Dr. Christopher Hart, of Emory Johns Creek Surgery, PC, and medical director of the Atlanta Bariatric Center, is one of a small group of surgeons in the country who have received training in Single-Site gallbladder surgery, and Emory Johns Creek Hospital is one of only two hospitals in the state to perform the procedure. To learn more about this procedure, visit emoryjohnscreek.com/robotics.

Healthy Events
Bariatric Surgery Information Seminar
The next seminars will be held July 11, 12, 17, 26, and August 1, 8, 9, 21, and 23.
Emory Johns Creek Hospital
Physicians’ Plaza, Suite 109
6335 Hospital Parkway

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No Needle, No Scalpel Vasectomy – Q&A with Emory’s Dr. Hsiao

Dr. Wayland Hsiao, Emory Urology

Dr. Wayland Hsiao

When the Urology Department of Emory Healthcare started offering no-scalpel, no-needle vasectomies as part of their men’s health treatment options, our ears perked up. Obviously, as the name implies, this type of vasectomy procedure allows doctors to forego the scalpel and needle combination used in traditional vasectomies, but what is used in their place? And what are the benefits? To get our questions answered, we went straight to the source, Emory’s own Dr. Wayland Hsiao, who is one of the surgeons performing the procedure. Our questions for Dr. Hsiao (and his answers) are below:

What exactly does it mean when we say no-scalpel, no-needle vasectomy? Can you describe the procedure?

A vasectomy is a procedure in which when the outflow of sperm through the vas deferens is interrupted to stop the outflow of sperm. It is a permanent form of male contraception. The procedure has no effect on sexual function. The no-scalpel vasectomy is a technique that allows us to perform the vasectomy through a puncture. The puncture is made in the scrotum and requires no suturing or stitches.

When compared to the conventional vasectomy, the primary difference is that the vas deferens tissues and blood vessels are spread aside from the surgical site rather than cut with a knife. This is less traumatic, and results in less pain and fewer postoperative complications. To numb the patient before the vasectomy, a Madajet injector is used. This is a tool that facilitates a highly pressurized lidocaine (anesthetic) to be sprayed on and through the scrotal skin to numb the skin and the underlying vas deferens. No needle is used in this anesthetic technique.

So, in terms of how the procedure is performed, what are the biggest differences?

We are able to replace the traditional scalpel with a specially design sharp clamp, which alleviates the need for an incision. The traditional incision is replaced by a small puncture hole which seals itself after the procedure. We also replace the needle with an anesthetic spray (diffused via the Madajet injector) that is applied to the scrotal skin and the vas deferens itself.

What are the benefits to no-scalpel, no-needle vasectomy?

Good question. There are several. With the no-scalpel vasectomy, there is less bleeding. In fact, the bleeding rate decreases from being seen in about 3% of patients down to 0.3%. In other words, there is 10 times lesser chance of bleeding. The infection rate after vasectomy is also decreased with the no-scalpel, no-needle technique. Infection is seen in 1.4% of patients with a traditional approach, while we only see infections inabout 0.1% of men undergoing the no-scalpel technique.

The bladeless vasectomy procedure is also faster, because the need for suturing is eliminated because there is no incision. The hole or puncture (2-3mm) created from the procedure will close up on its own.

Are there any risks associated with this procedure? If so, what are they?

The no-scalpel, no-needle vasectomy doesn’t come with any additional risks that we don’t already see with the standard vasectomy procedure, which include the risk of hematoma (with no-scalpel, this risk is significantly lowered to less than 0.5 %) and infection. As is true with all vasectomy procedures, the procedure is not guaranteed to be 100% effective. The general post-vasectomy failure rate is less than 0.5 % (1 in 500 short term failure; 1 in 4500 long term failure).

How long does the no-scalpel, no-needle vasectomy take?

The procedure takes about 30 minutes.

What can patients expect after the no-scalpel, no-needle vasectomy?

Patients can expect to experience swelling of scrotom for 2-3 days and bruising for up to a week. They might also experience a feeling of heaviness or dragging testes for 2-3 weeks.

How long is the recovery? How soon can I have sex post-procedure?

To achieve full recovery, patients should wait approximately 2 weeks after the procedure before participating in intercourse, but men should consult with their physician for guidance here.

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