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Recent Articles
July-September, 2009. Journal of the Society of Laparoendoscopic Surgeons. Miami, Florida.
Song, J.Y., Yordan, E.L., Rotman, C.A.: Incidental
Appendectomy During Endoscopic Surgery.
Journal of the Society of Laparoendoscopic Surgeons, Vol. 13,
Issue 3, Pages 376-383, July-September 2009
Click here to view PDF file of
the full article.
Abstract:
Background and Objectives: The first laparoscopic
appendectomy was performed over 25 years ago, and yet controversy
still exists over the open method vs. the laparoscopic approach, and
whether an incidental appendectomy is warranted. This study aimed to
evaluate our experience in performing a laparoscopic incidental
appendectomy and to address these issues.
Methods: A total of 772 laparoscopic appendectomies
were performed and analyzed and statistically evaluated.
Results: Mean age of the patients was 30.8±7.0
years. Mean operating time for an incidental appendectomy was
12.3±4.5 minutes. Most common pathology result was adhesions, and
the rarest was endometriosis. Of patients with confirmed
appendicitis, 75.8% did not have an initial preoperative diagnosis
of appendicitis. When warranted, 103 (13.3%) patients underwent a
second-look laparoscopy: 75.5% had no adhesions, 23.5% had mild
adhesions, 2% had moderate adhesions. Backward elimination logistic
regression revealed that endometriosis (P=0.016), endometrioma
(P=0.039), pelvic or abdominal adhesions (P=0.015) were associated
with a reduced likelihood of encountering appendicitis on pathology
examination. The complication rate was 0.13%. Anesthesia cost was
lower for an incidental appendectomy compared with an urgent one.
Conclusion: Laparoscopic incidental appendectomy is
safe and quick to perform. Due to the complex nature of confirming
the diagnosis of pelvic and abdominal pain, this study supports the
routine performance of an incidental appendectomy in the female
patient.
Affiliations: 1: TLC Medical Group, SC, Oak Brook
Institute of Endoscopy, Rush Medical College, St. Charles, Illinois,
USA 2: Oak Brook Institute of Endoscopy, Rush Medical College,
Downers Grove, Illinois USA
August 10, 2009. Daily Herald newspaper. Chicago, Illinois.
Fibroid removal could prevent unnecessary
hysterectomies
Click here to view PDF file of Page 1 of article.
Click here to view PDF file of Page 2 of article.
May 17, 2009. La Raza Spanish newspaper. Chicago, Illinois.
Alternativa a histerectomía
Médico hispano de Chicago gana premio por video de cirugía
avanzada
Click here to view PDF file of article.
Press Releases
May 5, 2009
Alternatives to Hysterectomy Video Honored
Prize awarded for advanced surgical technique that could prevent hundreds of thousands of hysterectomies each year.
Chicago, Illinois (PRWEB) May 5, 2009 – A medical video
demonstrating the minimally invasive technique of laparoscopic
multiple myomectomy was awarded First Prize by the American College
of Obstetricians and Gynecologists (ACOG) at their 2009 Film
Festival yesterday. ACOG presented the award to the Chicago-based
surgeons who authored the video, Drs. Jonathan Song, Carlos Rotman,
and Edgardo Yordan.
Of the 600,000 hysterectomies that take place each year in the
United States, more than 200,000 could be avoided according to Dr.
Rotman. “These hysterectomies are performed due to the presence of
benign tumors known as fibroids. While small fibroids are commonly
removed through traditional or laparoscopic surgery, removal of
larger ones is more difficult and requires special expertise. Over
the last 25 years, our team has developed new techniques and
instruments that allow us to remove multiple large fibroids while
preserving the uterus and often preserving fertility as well.”
Known as laparoscopic myomectomy, this minimally invasive surgical
procedure avoids large scars and overnight hospitalization by
utilizing small, specially-designed instruments inserted through
tiny (¼-inch) incisions. The use of sophisticated digital video
equipment allows clear visualization throughout the case.
The authors are members of the Oak Brook Institute of Endoscopy,
which introduced a key innovation known as the “SLAM” Technique.
SLAM stands for Simplified Laparoscopic Abdominal Morcellation, and
involves the use of a straight blade to cut large specimens safely
into long strips, which are then quickly and easily removed.
The prize-winning video demonstrates the team’s technique in the
case of a childless patient who had been told repeatedly at several
institutions that hysterectomy was her only option. Refusing to give
up on having children, she finally contacted Dr. Rotman and his
associates, who found her to be a good candidate for conservative
surgery. They removed several large fibroids – the largest measuring
almost 9 inches – and successfully reconstructed her uterus. The
patient later was able to give birth normally and is presently in
her second pregnancy.
According to Dr. Song, “too many hysterectomies are being performed
in the United States for benign diseases; the uterus does not need
to be easily sacrificed for fibroids.”
Dr. Rotman concluded, “The purpose of this video presentation was to
share our team’s techniques and philosophy with all other
physicians, with the hope that these procedures become more
widespread and patients everywhere will be given alternatives to
hysterectomy.”
Patients interested in contacting the authors can call (800)
244-0212 for Drs. Rotman and Yordan, and (630) 513-9160 for Dr.
Song. Drs. Rotman and Yordan are Associate Professors of Obstetrics
& Gynecology at Rush Medical College, and Dr. Song is an Assistant
Professor of Ob/Gyne there. All three are on staff at Chicago’s
Advocate Illinois Masonic Medical Center; in addition, Dr. Song is
on staff at Delnor Community Hospital in Geneva, Illinois.
ABOUT THE AUTHORS:
Jonathan Y. Song, MD, FACOG, FACS
A member of the medical staff at Delnor Community Hospital, Dr.
Song’s practice is limited to Gynecology and Surgery. He is board
certified in Obstetrics & Gynecology by the American Board of
Obstetrics & Gynecology (ABOG) and certified in Advanced Operative
Laparoscopy by the Accreditation Council for Gynecologic Endoscopy
(ACGE). Dr. Song is an Assistant Professor at Rush Medical College,
Rush University Medical Center, Department of Obstetrics and
Gynecology, and is also a faculty member for WebSurg and SurgeryU,
on-line sites for Minimally Invasive Surgical Education for
physicians. After graduating from Rush’s residency program, Dr. Song
was awarded a fellowship position in Advanced Laparoscopic Surgery
at the Oak Brook Institute of Endoscopy under the direction of Dr.
Carlos Rotman. Upon completion of his fellowship, Dr. Song entered
private practice and works for TLC Medical Group, along with Drs.
Gina Song and Joy Castrovillari in St. Charles, IL. Dr. Song
continues his association with the Oak Brook Institute of Endoscopy,
and in his spare time continues to contribute to surgical textbook
chapters, medical journals, and clinical meeting presentations.
Carlos A. Rotman, MD, FACOG, FACS
Founder and Director of the Oak Brook Institute of Endoscopy, Dr.
Rotman is board certified in Obstetrics & Gynecology by ABOG and
certified in Advanced Operative Laparoscopy by ACGE. An Associate
Professor of Obstetrics & Gynecology at Rush Medical College, Dr.
Rotman’s interest in laparoscopy dates back to his gynecology
residency days in the 1970s. In 1980, together with Dr. Harrith
Hasson, he started to use laparoscopy as a safe and effective way to
perform pelvic and abdominal surgery. The first project was to
improve access to the peritoneal cavity with a minimum of possible
complications, and the result was the Modified Technique of Open
Laparoscopy, now in use all over the world. Recognized in 1994 with
the Golden Laparoscope Award by the American Association of
Gynecologic Laparoscopists for the technique of Laparoscopic Pelvic
Lymphadenectomy, as well as with many other national and
international awards, Dr. Rotman and his colleagues have enjoyed
great recognition and respect for their pioneering and ongoing work,
teaching, and research geared to improving the quality of life of
patients worldwide.
Edgardo Yordan, MD, FACOG, FACS
Board-certified in both Obstetrics & Gynecology and Gynecologic
Oncology by ABOG, Dr. Yordan serves as Chairman of the Division of
Gynecologic Oncology at Stroger (Cook County) Hospital, and is an
Associate Professor of Ob/Gyn at Rush Medical College. Dr. Yordan
was nationally ranked twice by Good Housekeeping Magazine as one of
the “Best 400 Cancer Doctors in the USA” and as one of the “Best
Doctors for Women,” and was named one of “Chicago’s Top Doctors” by
Chicago Magazine. During his long association with Dr. Rotman and
the Oak Brook Institute of Endoscopy, for which he serves as
Co-Director, Dr. Yordan has won the Golden Laparoscope Award and
numerous national and international prizes.
MEDIA CONTACT:
Alfonso del Granado
Oak Brook Institute of Endoscopy SC
773-771-9177
info@oakbrookendoscopy.com
http://www.OakBrookEndoscopy.com
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