MDNews - Long Island

he says. "I treat my promise — I will care for you — as a sacred covena nt between my patient and myself. Should a patient need someone el se, I k now a not her physicia n ca n ca re for him or her just as well. The qua lit y of a surgeon's ca re is measured, in part, by the tota l qua lity of ca re the patient receives." Establishing trust is key to building this synerg y. "You work with people," Dr. Saldinger says of the trust-building process. "You make sure the leaders of other depart- ments know how good you are, and they have to come to know and trust us, too. We help each other — relationships grow over time and are critical to everything we do." ADVANCED ENDOSCOPY Often the first step of a patient's treatment plan, endoscopy can be used in a multitude of innovative approaches to gain key infor - mation about a patient's disease, obtain biopsy samples and perform curative and therapeutic interventions. At NYP Queens, Drs. Hussain and Kim deploy an advanced armamentarium of endoscopic techniques to help patients in a minimally invasive fashion, often providing initial relief and obtaining diagnostic informa- tion in the same procedure. " We use adva nced endoscopy pro- cedures as diagnostic and therapeutic tools — whatever the patient needs," Dr. Hussain says. "If the patient presents with a mass, we can diagnose it, and if they are not candidates for surger y or resection, we can provide therapeutic treatments as well. We tr y to ma ke it one-stop for patients. We ta ke a multi- disciplinary approach, so that we know what to expect and what to do when the patient arrives." O ne c om mon pr o c e du r e a t N Y P Q ueen s i s E RCP, du r i n g wh ich t he e n d o s c o p i s t s e a r c h e s f o r d i s e a s e within the bile duct, pancreas or liver. He or she uses an endoscope to arrive at the point at which the bile duct enters t he sm a l l i nt e s t i ne , t hen a c c e s s e s the bi le duct by mea ns of a catheter. Injecting contrast material via the cath- eter, the endoscopist uses fluoroscopic X-r ay i m a g i n g t o obt a i n v i su a l i z a- tion of the bile duct, pa ncreatic duct and ga llbladder. In addition to obta ining diagnostic i n for m a t i on , t h e e n d o s c opi s t c a n p e r f or m s om e t h e r a p e u t i c p r o c e - dures directly. " We place stents for patients w ith cholangiocarcinoma or pancreatic can- cer," Dr. Hussain says. "A cancer in the bile duct or the head of the pancreas can block the duct. We relieve that obstruc- tion by placing a semi-perma nent or permanent stent." O t her t herapies enabled by ERCP include ga llstone remova l and sphinc- terotomy, or the creation of an incision through which bile and pancreatic fluids can drain. The N Y P Queens physicia ns a lso employ SpyGlass technolog y for chol- a ng iopa ncreatoscopy, a n adva nce on traditiona l ERCP, which uses dig ita l i ma g i n g rat her t ha n f luoroscopy to obtain visual data. SpyGlass procedures have been found to increase diagnostic sensitivity, speed up procedures and lead to superior ga llstone clearance. "The basis of ERCP is simple endos- copy; that's the whole platform we start from," Dr. Kim explains. "But the endo- scope aspect is just the first part of it. Once you get to the ampulla, the opening into the bile duct and pancreas, ERCP ta kes off a nd becomes its own world. It's a matter of accessing the orifice and selecting the moda lit y that will best a l low us to do t hat . The nex t step is diag nosing the mass or removing the stone. If there's a mass to diagnose, we obtain adequate tissue. With SpyGlass technolog y, we use a 'scope w ithin a scope' approa ch , leav i n g one at t he a mpu l la a nd ex tendi ng t he ot her to obtain the tissue or remove the stone." SpyGlass technolog y is a lso used in lithotripsy, Dr. Kim notes. In this proce- dure, ga llstones are fragmented using a Meet the Physician: Sang Kim, MD SANG KIM, MD, Associate Program Director and Director of Biliary Endoscopy at NewYork-Presbyterian Queens and Assistant Professor of Clinical Medicine at Weill Cornell Medicine, obtained his medi- cal degree at Albany Medical College. He served his residency at St. Luke's-Roosevelt Hospital Center, followed by a fellowship in gastroenterology at New York Hospital Medical Center. Dr. Kim's work combines experience in research — he is widely published in gastroenterology and hepatology — with time spent in private practice. However, he has a deep attachment to NYP Queens since his fellowship. In fact, when asked to leave private work for a position at NYP Queens, he felt honored to accept the role. A member of several medical associations, Dr. Kim is board- certified in gastroenterology. Dr. Kim consults with a patient. 0 8❱❱❱❱❱ C O V E R F E A T U R E

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