MDNews - Long Island

COVER FEATURE Dr. Rivadeneira and Dr. Genua are devoted to providing advanced health care — in an environment of compassion — to patients and their families at both St. Catherine of Siena Medical Center and St. Charles Hospital. aware that treatment is available and are more likely to initiate a conversation with their physicians or seek care." Further, physicians from varying specialties are interacting in new ways and uncovering the methods in which they can collaboratively address patient Dr. Genua and Dr. Rivadeneira now provide specialized robotic surgery at St. Catherine of Siena Medical Center. Robotic surgery allows the surgeons to perform more difficult procedures in a less invasive manner. concerns such as prolapse. The Colon and Rectal Program at St. Catherine of Siena Medical Center meets this growing need with a dedicated pelvic floor laboratory, in which Dr. Genua employs several diagnostic modalities to gather specific information about pelvic function that cannot be captured with a CAT or PET scan. These exams include: + electromyogram — a measure of the electrical activity of the sphincter muscle fibers during squeeze and simulated defecation, and in response to certain reflexes + manometry — an assessment of anal muscular tone, rectal compliance and anorectal sensation + pudendal nerve testing — a quantitative assessment of the transmission speed of impulses along the pudendal nerve "The goal is to gain diagnostic informa- tion that cannot be obtained any other way and, of course, we are obtaining objective data," Dr. Genua says. "As I evaluate them, I often gain a much better understanding of patients' functions and the complaints that they may have had dif- ficulty explaining to me. I will often detect subtle findings that make a big difference for their treatments and outcomes." Navigating the Program Patients with a specific issue or an already specified diagnosis can be referred to Drs. Rivadeneira and Genua from primary care providers or specialists, such as gastroenterologists. For example, a patient may have visited his or her primary care provider with complaints of abdominal pain and then undergone a colonoscopy, which revealed colon cancer. The patient would then meet with Drs. Rivadeneira and Genua for a consultation and further diagnostic testing, such as blood work to measure the carcinoembryonic antigen levels and CAT and PET imaging. Following a discussion of appropriate surgical options, the patient undergoes

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