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Current Surgical Concepts

hip-painPain Syndromes are Sometimes Beyond Surgery Alone

Although surgery is effective for a multitude of pain processes, it cannot solve all of the syndromes occurring in patients. At times, surgery may even be counter-productive. What may have begun as a mechanical process, sometimes, if occurring for a long enough period, may have morphed into a Central or Peripheral Nervous System Syndrome, and may require additional maneuvers other than surgery. 

Currently, a new technology has emerged to treat elements of these syndromes. Dorsal Root Ganglion stimulation, or DRG, is a technology which places stimulator leads near the dorsal root ganglion in order to “short circuit” the pain syndrome. The leads can be placed easily and removed after a trial period. Early trials are promising.

In some cases, surgery will have effectively treated the mechanical problem. If however, a mechanical problem has lingered for a long period, the patient may fall into the category above, even after the surgical “fix,” and therefore require  an additional option. As new technologies like DRG emerge, surgeons and pain management specialists have increasing options to help their patients. 

Are Urgent Care Centers as good as Emergency Rooms?


So you ate that fish taco last night and you woke up this morning not feeling too good. You’re a little queezy, a little sweaty, and even toast for breakfast seems like a bad idea. You go to the Urgent Care Center because its close, easy, and, well, they’re doctors, right?

From a practical perspective, I can see why this seems like a good idea. From the surgeon’s perspective, which is one of a person who comes to the OR to operate on the “missed diagnoses” for appendicitis, diverticulitis, or perforated ulcers, I am very wary of the newest and latest. The simple fact is that the Urgent Care Center is only as good as the doctor, or other type of health care professional, covering at that moment. In most cases, there is no CT scanner to make the acurate diagnosis. In most cases, this is probably fine. Probably.

Sometimes, though, being the surgeon operating on the missed diagnosis, while doing the case which could have been more accurately diagnosed 72 hours earlier, I would disagree.

med-techAdvancing Technology in Surgery

As the age of minimally invasive surgery continues to progress, modalities for operating are becoming more and more sophisticated. Robotic surgery and Single port surgery are just two of the plethora of recent examples. In many ways, this phenomenon is driven by technological breakthrough. There are, however, other forces at work, not the least of which is the medical device industry. As with all advances, the advent of new technology has to be supported, but also evaluated to an exceedingly high degree. Just because a technology becomes available does not mean it is in the best interests of the patient or the society as a whole. To this end, General and Laparoscopic Surgeons is both learning and evaluating new technologies for its patients on a constant basis. Our recent attendance at both the American College of Surgeons (ACS), and the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) represents the continued devotion we have to patient care and the future.