MDNews - Long Island

combination of SpyGlass visua lization a nd a lithotripsy device, a llowing the endoscopist to pulverize the ga llstone while obser ving it directly. According to studies reported by Boston Scientific, the ma nufacturer of SpyGlass, stone clearance while under direct SpyGlass visua lization ca n reach 76 percent in a single session, or 90 percent overa ll. Yet another endoscopic tool deployed at N YP Queens hospita l is endoscopic u lt ra sou nd , i n wh ich t he physicia n introduces a n ultrasound device into the body for clear, minima lly invasive imaging of hard-to-reach structures. "Endoscopic ultrasound is performed from inside the intestine and looks at the surrounding organs," Dr. Hussain says. " The pur pose is to obta in dia g nosis, whether its a mass in the liver, pancreas, ga ll bladder, bile duct or a recta l lesion. We look at the lesion on the ultrasound; then we thread a fine needle through the stomach or intestine to obtain a biopsy sample. This is a minimally invasive way to obtain tissue diagnosis." SURGICAL INTERVENTIONS NYP Queens offers a wide range of sur- geries for conditions of the ga llbladder, pa ncreas a nd liver. Ma ny of these a re critical, lifesaving procedures involving years of training and practice. " We p er for m s ome l a pa r o s c opic s u r g e r i e s , t h o u g h m a n y a r e o p e n procedures," Dr. Sa ldinger ex pla ins. " U s i n g e p i d u r a l a n e s t h e s i a , w e provide extremely effective pain relief for patients, even when we must use large incisions." One complex procedure available at NYP Queens is the Whipple procedure for remov i n g t u mors i n t he hea d of the pa ncreas. As Dr. Sa ldinger notes, this procedure is no longer rare. Still, it t a kes g reat sk i l l, a nd su rgeons at N Y P Queens per form the procedure, Dr. Sa ldinger says. The W hipple procedure, or pa ncre- aticoduodenectomy, involves removing the head of the pa ncrea s, a long w ith the ga llbladder, duodenum and part of the stomach, as well as affected lymph nodes. Once the head of the pancreas has been removed, the surgeon reconnects the digestive tract and re-attaches the duct to drain bile from the liver. Despite the proximity of major arteries in this mu lt i-s t a ge pro c edu re, it t y pic a l ly goes smoothly. " We n e v e r h a v e t r a n s f u s i o n s ," Dr. Sa ldinger says. "Recovery is simple. That is the expectation that should be set. Patients stay in the hospita l just five to seven days, and then go home and are able to eat norma lly. When you tell patients you are going to remove large pieces from their digestive tract, they often expect a long recovery, but that's not the case." Dr. Saldinger also performs resection of hepatic a nd bilia r y tumors. These a re cha lleng ing procedures, he says, requiring careful planning. " You have to know when to say no," he says. " You have t o ident i f y when t o u se a dju nc t mea su res a nd t o a sk whether patients ca n receive chemo- therapy before resection to shrink their tumors. Sometimes this is helpful for pa ncreatic ca ncers. A ga in, it 's a mi x. We discuss ca ses at the tumor boa rd at Wei l l Cor nel l Medica l a nd obta in insights to g uide each case." MULTIDISCIPLINARY CONVERSATIONS FOR OPTIMAL CARE A s Dr. Sa ldinger suggests, conversa- tion is key to coming up with the right treatment pla n for each patient. Yet, those conversations ta ke place in con- text of streamlined, even urgent haste. It is this combination of a lacrit y a nd cross-disciplina r y collaboration that distinguishes NYP Queen's pancreatic and biliary program. "Our team of surgeons, endoscopists and oncologists a ll become involved in patient care," Dr. Hussain says. "Whether it's pancreatic cancer or a hepatobiliary malignancy, patients require treatment sooner rather than later, because these tend to be fast-growing tumors. Drs. Kim a nd Sa ldinger a nd myself look at the radiolog y together a nd come up with a treatment pla n, whether endoscopy alone or endoscopy followed by surgery. We meet patients in our office to discuss their care and plan. All their subsequent appointments a re made for them. A n Dr. Hussain reviews a patient's information. Meet the Physician: Syed Hussain, MD SY ED HUSSA IN, MD, Director of Endoscopic Ultrasound at NewYork- Presbyterian Queens, earned his medical degree from the Ross University School of Medicine in Portsmouth, Dominica. He served a residency at New York Hospital Medical Center of Queens, where he was appointed chief resident. He then completed a fellowship in gastroenter - ology at NYP Queens. Dr. Hussain is widely published in gastrointestinal medicine, especially on topics of endoscopy. He is board-certified in internal medicine and gastroenterology. M D N E W S . C O M /// M D N E W S L O N G I S L A N D ■ 2 018 0 9

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