What's New
Second Annual NOTES Course
The second annual NewYork-Presbyterian NOTES course drew close to 200 health professionals representing 20 states and 20 countries and five continents.
The ACCME-accredited event took place Dec. 15 and 16 at NewYork-Presbyterian Hospital/Weill Cornell Medical Center and Rockefeller University.
The annual conference focuses on natural orifice endoscopic and translumenal techniques, often referred to collectively as scarless surgery.
The course was led by surgeons and physicians from Columbia University and Weill Cornell medical centers, including Columbia's Marc Bessler, MD and Peter Stevens, MD, who performed one of the first scarless gallbladder removals during 2008 and pioneered a laparoscopic-camera-assisted version of the procedure during 2007.
Use of the procedure is being expanded to include weight loss surgery and abdominal operations including appendectomy.
Genetic Testing for Colorectal Cancer
A Case Study
A small percentage of colon cancers are caused by a rare inherited disease called Lynch Syndrome, or Hereditary Nonpolyposis Colon Cancer (HNPCC).
The syndrome, caused by mutations of several genes, causes carriers to have about an 80% lifetime risk of developing colon cancer, as well as an increased risk of endometrial, ovarian, gastrointestinal, hepatobiliary, and other cancers.
For a Broadway performer in her 40's who had the mutation, knowing about her genetic risk gave her the opportunity to choose her path and be proactive about her care.
But not all patients are prepared to undergo genetic testing or to share such information with their families.
Natural-Orifice Transluminal Endoscopic Surgery (NOTES) Takes Next Step
Marc Bessler, MD
NEW YORK (Jul 28, 2008) In April of last year, surgeons at NewYork-Presbyterian Hospital/Columbia University Medical Center made headlines by removing a women's gallbladder through her uterus using a flexible endoscope, aided by several external incisions for added visibility. Now, they have performed the same procedure without a single external incision in what surgeons report may be the first surgery of its kind in the United States. Led by Marc Bessler, MD, the procedure is offered as part of an ongoing clinical research trial and could prove to have advantages over traditional endoscopic surgery, including reduced pain , quicker recovery time and absence of visible scarring.
Read the NYP press release.
Dr. Amory Honored
Spencer Amory, MD
Spencer Amory, MD, received the NYPH/Allen Pavilion physician of the year award for 2007.
Also in 2007, Dr. Amory received the Leonard Tow Award for Humanism in Medicine from the Arnold P. Gold Foundation.
Hospital Researchers Pursue Incisionless Endoscopic Surgery
In recent years, rapidly emerging technologies and improved techniques have brought minimally invasive endoscopic surgery closer to a once-elusive goal: incisionless surgery.
At the forefront of this trend, Columbia and Weill Cornell physicians at NewYork-Presbyterian Hospital have been developing NOTES™ (natural orifice translumenal endoscopic surgery) in both research and clinical settings.
Incisionless Surgery with Natural Orifice Techniques
Natural Orifice Translumenal Endoscopic Surgery, or NOTES, is a new method of performing minimally invasive surgery through the mouth, anus, or vagina.
Drs. Marc Bessler, Peter Stevens and Dennis Fowler have successfully performed the first U.S. transvaginal gall bladder removal operation (cholecystectomy) with limited laparoscopic assistance as part of a larger IRB approved study.
In addition to transvaginal removal of the gallbladder, the Columbia team is conducting minimally invasive procedures for appendectomy, gastroesophageal reflux, and weight loss surgery.
TEMS for Rectal Tumors: An Alternative to Major Abdominal Surgery
Until recently, many patients with precancerous growths or early cancers of the rectum had to undergo open surgery with a long recovery period and risks of complications.
Now, a new addition to the surgeon's toolkit, transanal endoscopic microsurgery (TEMS), can eliminate the need for major surgery for many of these patients.
Columbia Physicians Perform First U.S. Transvaginal Cholecystectomy
Marc Bessler, MD
On March 20, 2007, Drs. Marc Bessler, Peter Stevens and Dennis Fowler successfully performed the first U.S. transvaginal gall bladder removal operation (cholecystectomy) with limited laparoscopic assistance as part of a larger IRB approved study. The transvaginal surgical approach enables access to the abdominal cavity with minimal or no external incisions or scars. In this first procedure, only three tiny laparoscopic incisions were made as compared to the customary four substantially larger incisions needed for a traditional laparoscopic cholecystectomy. "The patient felt almost no pain on recovery, other than some minor discomfort at one laparoscopic site. We believe this approach will provide patients the benefit of reduced pain, faster recovery time and fewer scars than the traditional laparoscopic alternative," said Dr. Stevens, who is Director of Endoscopy at NewYork-Presbyterian Hospital/Columbia University Medical Center. "As we enroll additional patients and gain experience with this technique we expect to reduce the number of laparoscopic ports—with the goal of a true incisionless procedure," said Dr. Bessler. The operation was covered in an April 20, 2007 New York Times feature about the surgical technique, known as natural orifice translumenal endoscopic surgery, or NOTES. The groundbreaking operation was also featured in United Press International (April 20) and ABCNews.com (April 23).
Take Notes
New Surgical Technique and Technology May Reduce Invasiveness of Laparoscopic Surgeries
Natural Orifice Translumenal Endoscopic Surgery, or NOTES, is a new method of performing minimally invasive surgery through the mouth, anus, or vagina. Trans means "across," and lumen refers to the space of an organ. Still in the investigational phase, NOTES has been successful in animal studies of gall bladder removal (cholecystectomy), appendectomy, tubal ligation, and other abdominal operations.
The Columbia University Pancreas Center
The Center for Esophageal Disorders at Columbia University Medical Center, under formation in 2007, will advance the level of care for patients with esophageal cancer, achalasia, Barrett's esophagus, gastroesophageal reflux, and other esophageal disorders.
According to Marc Bessler, MD, Director of Laparoscopic Surgery at NewYork-Presbyterian Hospital, the center will offer the full spectrum of treatments including dietary advice, medical interventions, endoscopic procedures, and surgery, with an emphasis on laparoscopic surgery whenever possible.
Collaborating leaders of the new center include Joshua R. Sonett, MD, Chief of General Thoracic Surgery, Charles J. Lightdale, MD,
Director of Clinical Gastroenterology, and Peter D. Stevens, MD, Director of Endoscopy, Department of Medicine.
As an innovator of minimally invasive surgical techniques, Dr. Bessler has pioneered important methods of performing bariatric and abdominal surgeries. He now looks forward to bringing this expertise to the treatment of esophageal cancer: "Not many hospitals offer minimally invasive esophageal procedures," he explains. This new multidisciplinary center will incorporate the specialized expertise of gastroenterologists, nurse practitioners, surgeons, abdominal and thoracic surgeons, oncologists, radiation oncologists, and specialists in minimally invasive surgery.
To learn more call 201.346.7001.
Penelope™ Tries Her Steady Hand at Surgery
Penelope handing an instrument to Dr. Treat
Penelope™, a one-armed robotic scrub technician, will finally get to try her hand at surgery in March 2005. "It will be the robot's first surgical case, done as part of a research study to validate that the robot is working as expected," says Dr. Michael R. Treat, MD, Associate Professor of Clinical Surgery at Columbia University College of Physicians & Surgeons. Dr. Treat conceived of the idea for Penelope in March 2001. Shortly after, he formed Robotic Surgical Tech, Inc., a spin-off company of NewYork-Presbyterian Hospital and Columbia University. The company, located in Bronx, New York, is solely dedicated to designing surgical robots.
