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By SMH Webmaster on 4/16/2013 8:53 AM
Treatment options depend on the likelihood of cancer spreading or the amount that has already occurred; the age, and the overall condition of the patient. An elderly patient with a type of prostate cancer that is very slow growing (low Gleason Score) and few or no symptoms may be a candidate for active surveillance. Tests are performed to evaluate the spread of the cancer. No treatment is actually started at the time of diagnosis.“Since prostate cancer can be very slow growing, there is no reason to subject the patient to aggressive procedures and painful treatment if it’s not necessary,” said Strickland. Radiation TherapyRadiation therapy is used for the treatment of some types of prostate cancer. External radiation therapy sends radiation toward the cancer, while internal radiation therapy is the placement of a radioactive substance inside the prostate near the cancer. The risk of bladder or rectal cancer increases if radiation therapy is used. Impotence and urinary problems may also occur.Hormone TherapyHormone...
By SMH Webmaster on 3/18/2013 8:06 AM
Prostate cancer is the most common non—skin cancer among men in the United States. In fact, one in six men will develop it. John Strickland, MD, of Kansas City Urology Care has a passion for prostate health and encourages men to keep track of their PSA levels. It can be as simple as taking your blood pressure and can save lives. Prostate health is evaluated by PSA levels (from a blood test) and a digital rectal exam. Men over the age of 40 should have an annual physical, which includes prostate evaluation. PSA levels are particularly important in men with a family history of prostate cancer. Even if your level is considered normal, further evaluation is necessary if it’s much higher than the previous year. PSA levels are elevated in patients with prostate cancer, but also in those with infection or inflammation of the prostate. The following symptoms often occur after the cancer has spread:• Weak or interrupted flow of urine• Frequent urination (especially at night)• Trouble urinating• Pain or burning during...
By SMH Webmaster on 1/29/2013 11:05 AM
There’s no doubt that robotic surgery has changed the traditional hysterectomy, allowing for a completely different experience than what your mother or grandmother once had.Thanks to the latest advances in technology, robotic surgery has changed the traditional hysterectomy. OBGYN Cranston Cederlind, MD, has delivered well over 5,000 babies and counting at Shawnee Mission Medical Center (SMMC). Throughout his career, he has stayed on the cutting—edge long enough to deliver you and your children, while also being the first in the Midwest to perform a supra—cervical hysterectomy. During the 30s and 40s, hysterectomies were done as open abdominal procedures that involved large incisions in the lower abdomen, and oftentimes led to a hospital stay between seven and 10 days. A supra—cervical hysterectomy was completed where the uterus was removed, but the cervix was left in place. The rationale behind that was that if the cervix was removed with the uterus, gravity would impact the internal organs and prolapse (protrusion...
By SMH Webmaster on 9/7/2012 2:25 PM
In the heat of the summer, fireflies can be seen outside after dark. At Shawnee Mission Medical Center (SMMC), Robotic Surgeon Scott Montgomery, MD, is seeing a different type of Firefly™ in the operating room (OR).

Montgomery, who performed his first robotic urologic surgery in 2003, believes the Firefly technology is a tremendous advancement in robotic—assisted surgery with several patient benefits. The enhanced imaging incorporates a green colored dye called IndoCyanine Green (ICG) to help identify the renal vessels and allows for selective arterial clamping during kidney sparing surgery for patients who have kidney cancer. Montgomery and his partners at Kansas City Urology Care are among a select group of surgeons in the world to utilize this technology. SMMC was one of 85 medical institutions in the nation to implement Firefly in the fall of 2011. During the procedure, the ICG is injected intravenously. The specially—designed camera can view the images of tissue and surrounding blood vessels illuminated...
By SMH Webmaster on 8/1/2012 2:21 PM
Patients undergoing a prostate procedure have similar questions. Will the cancer be removed completely? Will it return? Will the surgery impact continence? What degree will I be able to function sexually after the surgery? These are all important factors in determining the success of the procedure.

Urologist David Emmott, MD, says precision is key when it comes to preserving nerve fibers and other structures in the removal of prostate cancer. Although the cancer starts growing within a contained section of the prostate, it eventually expands beyond that area. The nerves that are essential for erectile function and continence travel within a one to two millimeter layer, so preserving the nerves while removing the cancer can be a challenge!

Emmott approaches the prostate from a different angle that avoids injury by staying away from the nerves as much as possible. Experience has given him the knowledge to identify what to leave and what must go. Patients can be assured their surgery will be performed...
By SMH Webmaster on 5/14/2012 3:23 PM
Christopher Lynch, MD, an OB/GYN practicing at Shawnee Mission Medical Center (SMMC), has been performing minimally—invasive surgery for the past 15 years. In 2007, Lynch took that experience one step further and became the first surgeon in the Kansas City area to perform a hysterectomy using the da Vinci™ Surgical System.

Lynch said today's patients are very well—educated and know what techniques are available. He said patient demand is why he initially trained on the da Vinci. Patients seek robotic—trained surgeons because they are aware of the benefits.

SMMC was the first hospital in a five—state region to perform minimally—invasive surgery using the da Vinci and continues to be a leader in the field. The hospital now operates two surgical robots focusing on a variety of specialties including gynecology, urology, reproductive endocrinology and general surgery. The robot is controlled by a physician and uses 3—D magnification and 540 degree articulation, allowing for intricate maneuvers that aren't...
By SMH Webmaster on 4/13/2012 3:46 AM
As the coordinator of the Surgical Robotics program at Shawnee Mission Medical Center (SMMC), I often get questions about robotic surgery. Through this blog, I will share information and patient experiences we encounter each day at SMMC.

For some people, the idea of robotic surgery is a bit complex. The visual created is one of a robot stomping around the operating room, similar to R2D2.

• What if the robot fails?

• What if its power source goes out?

• What if the robot has been programmed incorrectly?

In the Operating Room, the hand movements of the surgeon are replicated by the robot. Robotic— trained surgeons carefully manipulate robotic arms to perform precise maneuvers, which were previously not possible with the naked eye and human hands.

The EndoWrist™ instrument tips have 540 degrees of articulation, yet can easily pass through dime size incisions. When the surgeon sets down the robotic arms, they make no movement until the surgeon picks them up again. Robotic—...
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