Medical Innovations

Tumor removal easier for patients

May 25, 2009 -- For patients at Springfield Clinic, the removal of certain skull based tumors has been made easier through a minimally invasive endoscopic procedure. Robert Finch MD, specialist in Otolaryngology (ENT) and Brian Russell MD, neurological surgeon, collaborate on a remarkable surgical method which removes a tumor, with image guidance, through the patient’s nose.

Karen Keen, a local registered nurse, was recently diagnosed with a pituitary tumor. “I was having headaches and some visual changes, so for a long time, I thought it was my glasses. I finally saw the nurse practitioner at Dr. Morton’s office and she ordered an MRI, which showed a pituitary tumor pressing on my right optic nerve,” Karen recalled. “I’m a nurse, so I did quite a bit of research and talked to a lot of people after my tumor was discovered. This was surgery on my brain, so I wanted to make sure I knew all the options.”

For many years, the most common tumor removal method involved an incision inside the patient’s upper lip. Following surgery, the patient’s nose would be packed for days to absorb drainage from the surgical site, which would frequently result in an elongated hospital stay, as well as physical symptoms of numbness, discomfort, and difficulty eating and drinking.

Karen was planning on going out of state to have the procedure done when she discovered Drs. Finch and Russell performed it locally. “I knew both of these doctors through my work, so I was very confident in their abilities and experience. I would not have done it any other way.”

The procedure, technically known as Endoscopic Transsphenoidal Hypophysectomy, allows patients to recover more quickly with less pain and fewer side effects. Dr. Finch noted, “Our patients can often go home the next day and there’s little or no packing to manage. Patients may experience a little tenderness or mild congestion, but the difference in the recovery is days instead of weeks.”

“The surgery from start to finish was done in about five hours. I was in on Monday, went home on Tuesday and was back to work in three weeks instead of six or eight.” Karen added there was very little pain and she required minimal post operative medication.

Dr. Robert E. Finch

Dr. Finch is a board-certified specialist in Otolaryngology/Head & Neck Surgery. A native of Tuscaloosa, Alabama, he earned a medical degree from University of Alabama School of Medicine in Birmingham, Alabama, followed by an internship at St. Louis University School of Medicine in St. Louis, Missouri. He continued his medical training with a residency in Otolaryngology at University of Wisconsin Center for Health Sciences in Madison and completed a fellowship in Head & Neck Surgery, also at Wisconsin.

After several years in private practice, he joined Springfield Clinic in 1987.

He was the first surgeon in the Springfield area to perform sinus endoscopy and continues to be a leader in bringing advanced and innovative treatments to Central Illinois. Dr. Finch has special interests in voice disorders and uses video-stroboscopy of the larynx, a new and highly advanced diagnostic tool for diagnosing and treating voice disorders.

Dr. Brian K. Russell

Dr. Russell is a graduate of SIU School of Medicine in Springfield, Illinois. Following medical school and internship at SIU, Dr. Russell completed his training in Neurosurgery at University of Kansas Medical Center, College of Health Schienes and Hospital in Kansas City, Missouri.

With more than 20 years in medical practice, Dr. Russell maintains board-certification in Neurological Surgery. He is a member of the American Association of Neurological Surgeons, the Congress of Neurological Surgeons and the Illinois State Neurological Society in addition to several other professional associations.

He provides comprehensive evaluation and treatment in surgical disorders of the brain, spine and peripheral nerves. Dr. Russell’s special interests include lumbar disk disease and pituitary tumors.

Cartilage Transplant Gives Knees New Life

For many years, the treatment options for patients suffering with Articular Cartilage defects or damage have been limited, but a revolutionary new procedure performed by Dan Adair, MD at Springfield Clinic offers hope.

Dr. Adair, specialist in Orthopedic Surgery, is one of the first in the area to perform chondral allograft transplantation, a method which removes the immature cartilage cells from a human tissue donor and transplants them into the host patient’s knee. The immature cells divide normally and create a more natural replacement for the patient’s missing or damaged cartilage. The procedure has been approved by the FDA and is endorsed by the International Cartilage Repair Society.

Articular Cartilage is a highly complex human tissue that provides cushion between bones in the knee and creates a smooth surface for its motion. Attempts to produce an artificial replacement for the tissue have met with little success. “Researchers thought they were ten years away about twenty years ago. Everything I read says we’re at least another ten years away from a product that can simulate our own tissue,” commented Adair.

More common alternatives, like Autologous Chondrocyte Implantation, where cartilage cells are grown in a lab, or Microfracture surgery, where tiny fractures are made in the bone to stimulate re-growth of the tissue, lack the durability desired. In some cases, knee arthroplasty (knee replacement surgery), depending on the patient’s condition, has yielded the best results.

“We’re very good at metal and plastic, but we’re looking for better solutions,” said Dr. Adair. “This new procedure allows us to biologically replace cartilage. The quality of the repair appears to be superior to traditional methods, especially when performed on younger patients.” According to Adair, chondral allograft transplantation is also less painful for the patient and is technically easier than alternatives, which makes it less expensive.

For more information, contact the Springfield Clinic Department of Orthopedic Surgery at 217.528.7541.

Dr. Daniel Adair

Dr. Adair, a native of Decatur, Illinois, earned his medical degree from SIU School of Medicine in Springfield, Illinois and performed an internship at Bowman Gray School of Medicine of Wake Forest University in Winston-Salem, North Carolina. Immediately following, he completed a residency in Orthopedic Surgery, also at Wake Forest, and served as the program’s Chief Resident from 1982 to 1983.

Dr. Adair has been a part of Springfield Clinic’s Department of Orthopedics & Sports Medicine since 1984. He serves as Medical Director of SportsCare of Illinois, in addition to holding several other positions within the local healthcare community.

Dr. Adair is certified by the American Board of Orthopedic Surgery and performs Orthopedic Surgery with special emphasis on total joint replacement and sports medicine. His practice focuses on all things related to the knee, including ACL repair, cartilage repair and replacement, and arthritis of the knee.

As an avid athlete, Dr. Adair advocates fitness as the key to maintaining musculoskeletal health. He encourages all patients to remain active, eat healthy and follow a wellness program with regular checkups and age-appropriate screening.

Innovative Endoscopic Procedure Available at Springfield Clinic
(view EUS video)

For years, the use of imaging in medicine has helped detect abnormalities in the digestive tract, including the esophagus, stomach, pancreas and liver. Until recently; however, patients would still require a biopsy or surgical resection to determine the nature of the problem. Patients would often undergo invasive procedures, which would require hospital stays, and, at times, lengthy periods of waiting for results. Now, a technologically advanced procedure performed at Springfield Clinic offers an alternative solution.

Ashish Chopra, MD, specialist in Gastroenterology at Springfield Clinic, is specially trained in the new diagnostic procedure known as Endoscopic Ultrasound (EUS) with Fine Needle Aspiration (FNA).

Endoscopic Ultrasound (EUS) combines endoscopy, introduced through a patient’s mouth, and ultrasound to explore internal organs. When a tissue sample is required, Fine Needle Aspiration, or FNA, uses a thin needle attached to the endoscope. The needle can be used to remove tissue samples, guide treatments, analyze masses, and help diagnose conditions. Using EUS with FNA, physicians are able to get a deeper biopsy, and can look through thin layers of tissue with minimal invasion. EUS with FNA can even be used to determine the stage of cancer once it discovers a nodule or mass.EUS with FNA has been available in larger markets for years. “Up until a few years ago, patients in the Springfield area were referred to Chicago or St. Louis for this procedure,” said Chopra. “Now it can be done locally.” Dr. Chopra performs EUS with FNA as an outpatient procedure in a hospital setting, but expects the service to soon be offered at Springfield Clinic’s Ambulatory Surgery & Endoscopy Center.

Dr. Chopra stresses the importance of having access to this kind of procedure in Springfield. “It’s here, it’s safe, and it offers good diagnostic accuracy to determine what’s going on.”

Dr. Ashish Chopra

Dr. Chopra, a native of Chicago, Illinois, earned his medical degree from St. Louis University School of Medicine. Immediately following, he completed a residency in Internal Medicine at Mayo Clinic, followed by a residency in Gastroenterology at his alma mater, St. Louis University School of Medicine. Dr. Chopra was awarded two fellowships, one in Hepatology & Liver Transplantation at Mayo Clinic, and another in Advanced Endoscopy at University of Illinois in Chicago.

Dr. Chopra joined Springfield Clinic in July of 2010. He is Board Certified in Gastroenterology and Internal Medicine.

New Drug Reverses Vision Loss

September 11, 2009 - For many years, patients suffering with Retinal Vein Occlusion (RVO), a common but serious inflammation of the retina, faced almost certain vision loss and eventual blindness. But a new treatment, the first and only to be approved by the US Food and Drug Administration (FDA), offers hope for these patients. 

The new medication, commercially known as Ozurdex, is contained in a thin implant, similar in size to a pencil lead, which is injected through a small needle into the area behind the lens known as the vitreous. The implant slowly dissolves, releasing a continuous and predictable dose of cortosteroid dexamethazone, a medication which reduces inflammation and helps reverse the vision loss caused by Retinal Vein Occlusion.

Amish Purohit, MD, a Retinal Surgeon with Springfield Clinic’s Department of Ophthalmology, has been involved with the development of the drug since the Phase I clinical trials began more than five years ago. Dr. Purohit recently served as one of 15 investigators from across the country to review the final clinical data and make recommendations to the FDA. He is now one of the first in the country to offer the therapy.

“I’ve treated hundreds of patients with this drug as part of clinical trials and am so excited that I can now offer it to my patients as an FDA approved therapy,” said Dr. Purohit.

RVO is common among the elderly and is frequently the result of natural aging or other contributing factors like high blood pressure and glaucoma. Symptoms often include dramatic blurring or loss of vision. Until now, only experimental therapies have been available, many of which have been costly, time-consuming or unpredictable in terms of their effectiveness.

“Ozurdex represents a major advancement in the treatment of RVO,” noted Dr. Purohit. “We can deliver a single dose of medication that can last up to nine months. This less invasive approach translates to improved patient comfort and fewer risks of bleeding and infection.”

Dr. Purohit added, “I treated my first patient earlier today and could not be happier with the results. The injection did not cause any pain or discomfort and the patient indicated it was much easier than she thought it would be.”

For more information about vision loss or its treatment, contact Amish Purohit, MD at Springfield Clinic’s Department of Ophthalmology by calling 217.528.7541.

Dr. Amish Purohit

Dr. Purohit specializes in diseases and surgery of the retina and vitreous, macular degeneration and diabetic retinopathy. He is board certified in Ophthalmology.

Dr. Purohit joined Springfield Clinic in 2007, following the completion of a fellowship in Vitreo Retinal Disease & Surgery at the prestigious UCLA Jules Stein Institute in Los Angeles, California. Dr. Purohit earned his medical degree from Emory University of Medicine in Atlanta, Georgia, followed by an internship at Baylor College of Medicine in Houston, Texas. His training in Ophthalmology was conducted at University of Maryland School of Medicine in Baltimore and prior to his fellowship at UCLA, Dr. Purohit completed a fellowship in Cornea Research at Emory University Department of Ophthalmology.

Dr. Purohit is actively involved in clinical research and continues to seek out innovative new therapies to repair and restore vision.

In traditional open surgery, the physician makes an incision, then widens it to access the anatomy. In traditional minimally invasive surgery the surgeon operates using rigid, hand-operated instruments, which are passed through small incisions and views the anatomy on a standard video monitor. At Springfield Clinic, we are proud to offer an alternative solution.

Specialties offering robotic surgery: Colon and Rectal Surgery, Gynecologic Oncology, Obstetrics and Gynecology, Otolaryngology/Ear, Nose, Throat (ENT), Urology

Some of the major benefits of robotic surgery, using the daVinci Surgical System include:

• greater surgical precision
• increased range of motion
• improved dexterity
• enhanced visualization
• improved access

Benefits experienced by patients who undergo robotic surgical procedures may include:

• a shorter hospital stay
• less pain
• less risk of infection
• less blood loss
• fewer transfusions
• less scarring
• faster recovery
• quicker return to normal daily activities

None of these benefits can be guaranteed, as surgery is necessarily both patient- and procedure-specific.

Springfield Clinic offers robotic surgery options for the following specialties:

COLON AND RECTAL SURGERY:

James Thiele, MD

• Right Hemicolectomy
• Low Anterior Resection
• Rectopexy
• Abdominoperineal Resection

Download Podcast  Listen as Dr. Thiele discusses colon and rectal cancers and robotic surgery.

• Right Colon Resection for diverticulitis or cancer 
• Sigmoid Colon Resection for diverticulitis or cancer
• Low Anterior Resection for diverticulitis or cancer
• Abdominoperineal Resection for diverticulitis or cancer
• Rectopexy for rectal prolapse

GENERAL SURGERY:

Eric High, MD

• Single Incision Gallbladder Removal
• Nissen Fundoplication for gastroesophageal reflux disease (GERD)
• Hiatal hernia
• Removal of the Adrenal Gland
• Inguinal Hernia
• Splenectomy 
• Distal pancreatectomy

Kristofer Mitchell, MD

• Single Incision Gallbladder Removal
• Nissen Fundoplication for gastroesophageal reflux disease (GERD)
• Hiatal hernia
• Removal of the Adrenal Gland
• Inguinal Hernia
• Splenectomy 
• Distal pancreatectomy

John Shaffer, MD

• Hysterectomy for Endometrial Cancer

OBSTETRICS & GYNECOLOGY:

Richard Eden, MD

• Hysterectomy
• Myomectomy for Fibroids
• Ovarian Cystectomy
• Salpingo-oophorectomy
• Endometriosis Resection

Ernest E. Ertmoed, MD

• Hysterectomy
• Ovarian Cystectomy
• Salpingo-oophorectomy

William Putman, MD

• Hysterectomy for Large Uteri
• Myomectomy
• Pelvic Floor Reconstruction
• Sacrocolpopexy
• Endometriosis Resection
• Ovarian Cystectomy
• Removal of Ovaries

Toni Quinn, MD

• Hysterectomy for Large Uteri
• Myomectomy
• Pelvic Floor Reconstruction
• Sacrocolpopexy

Dustin Stehling, MD

• Hysterectomy, including for Large Uteri
• Myomectomy for Uterine Fibroids
• Endometriosis Resection
• Ovarian Cystectomy
• Removal of Ovaries

Donna Sweetland, MD (click here for patient testimonials)

• Hysterectomy for Large Uteri
• Removal of Ovaries
• Ovarian Cystectomy
• Myomectomy for Uterine Fibroids
• Endometriosis Resection
• Sacrocolpopexy for uterine or vaginal prolapse

Download Podcast  Listen as Dr. Eden, Dr. Putman and Dr. Quinn discuss robotic hysterectomy.

Download Podcast  Listen as Dr. Sweetland discusses robotic gynecologic procedures.

OTOLARYNGOLOGY/ENT:

Nathan Joos, MD

• Base of Tongue Cancer
• Obstructive Sleep Apnea Surgery
• Throat and Laryngeal Cancers
• Thyroidectectomy

UROLOGY:

David Lieber, MD

• Pyeloplasty
• Partial Nephrectomy
• Prostatectomy
• Cystectomy

Revolutionary GERD Procedure Available in Springfield

January 5, 2011 – Patients who suffer from diseases like acid reflux often suffer in silence, taking over-the-counter and prescription medications to dull the effects without treating the condition itself, rather than undergoing a painful surgical procedure. Thanks to a revolutionary new procedure performed in a local setting exclusively by Springfield Clinic General Surgeons James Fullerton, MD, and Kristofer Mitchell, MD, patients can find relief without invasive surgery.

Gastroesophageal reflux disease (GERD) is a condition in which stomach contents can flow back into the esophagus causing inflammation. Treatment often involves long term medical therapy or an invasive abdominal surgery.

Open and laparoscopic surgical procedures have been used to treat GERD effectively for years. Unfortunately, even laparoscopic surgery has the potential for complications. For this reason, very few GERD patients currently choose surgery to treat their condition.

As opposed to laparoscopic and open procedures currently used to treat the condition, Transoral Incisionless Fundoplication (TIF) is a new procedure performed endoscopically. While the patient is under anesthesia, the recently developed EsophyX device is introduced into the stomach through the mouth. Folds of stomach tissue are gathered together creating a barrier to prevent reflux, leaving no scars and causing very little discomfort. Dr. Fullerton and Dr. Mitchell are the first surgeons in Springfield to introduce this procedure.

“Studies indicate after two years following this procedure, 79% of patients are able to stop taking medication for reflux disease completely,” said Dr. Fullerton. “Between the lower cost of the procedure versus surgery, and the cost of medication over time, there is certainly the potential for a lower overall cost.”

Typically completed in under an hour, the TIF procedure is performed under general anesthesia in a hospital setting. After an overnight stay, most patients can go home the following day, and are able to return to their regular activities within that week.

Dr. James Fullerton

James K. Fullerton, MD is a board-certified general surgeon, with special interests in laparoscopic surgery, surgical endoscopy and ERCP. A native of Janesville, Wisconsin, Dr. Fullerton attended the Medical College of Wisconsin in Milwaukee, where he received his medical degree. He was named Chief Resident in 2004 during the completion of his General Surgery residency at SIU School of Medicine in Springfield.

Immediately following, Dr. Fullerton joined Springfield Clinic’s Department of General Surgery and practiced briefly until his acceptance at University of Louisville in Louisville, Kentucky. During his leave of absence, Dr. Fullerton completed an Endoscopy and Interventional ERCP Fellowship, and returned to practice in the Clinic’s Department of General Surgery in 2006.

Dr. Kristofer Mitchell

Kristofer J. Mitchell, MD is a board-certified general surgeon, with special interests in laparoscopic surgery and surgical critical care/trauma. A native of Janesville, Wisconsin, Dr. Mitchell attended Southern Illinois University School of Medicine in Springfield, where he completed his residency soon after. Dr. Mitchell was then awarded a Surgical Critical Care/Trauma fellowship at University of Californa in San Diego.

Dr. Mitchell is board certified in General Surgery and Surgical Critical Care/Trauma.