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Moving Medicine Forward

by Lindsey Getz

The field of medicine is ever-changing. Over the years, doctors and researchers have continual-ly found better ways to treat patients. New innovations are constantly leading us to not only live longer lives—but higher quality ones. We recently caught up with some South Jersey-area doc-tors in several different fields of medicine to find out the latest advances in our region.

Matters of the heart
The outcome for patients with heart problems has improved over the years for a variety of reasons. Among them is better mechanical support for those who have heart failure. Dr. Wade Fischer, surgical director of Heart Transplant and Mechanical Circulatory Support at Hahnemann University Hospital has been performing heart transplants for more than 15 years and has exten-sive experience in mechanical support and ventricular assist devices. Fischer says that the new portable ECMO—extracorporeal membrane oxygenation—device is providing even greater pos-sibilities for patients and in turn, improving outcomes.

“The portability of the new device allows us to reach patients in locations where they otherwise might not have received the level of care they need to survive,” Fischer says. “But now we have a single, portable unit that can go to the patient in a hospital where they don’t have the same re-sources we do here at Hahnemann. Utilizing ECMO support we can bring them by helicopter to us and provide them a better chance of survival. With the use of these new, more portable devic-es, the patient outcomes are improving.”

Treating back pain
It’s estimated that as much as 80 percent of the population will experience back pain at some point in their lifetime and for some, it can be debilitating. Fortunately, science is finding a solution. Dr. Scott Jarmain, interventional spine/pain management specialist from Coastal Spine in Mount Laurel says that the greatest recent advances in pain management have been in the field of spinal cord stimulation.

According to Jarmain, dorsal spinal cord stimulation (SCS) is a technology that is utilized to re-lieve and control chronic pain in the extremities, lower back and neck, as well as other regions of the body. With recent upgrades and modifications in this device and with new technology that has recently come out, dorsal spinal cord stimulation is now more effective in controlling pain than ever before. It is also more versatile and safer.

“In the past, the presence of an SCS system in the body was an obstacle to getting an MRI,” Jar-main explains. “But the latest spinal cord stimulation systems are MRI compatible, which means a patient with an SCS system inside them can now get an MRI on any part—or at least some parts of the body, depending on the system.”

Bariatric surgery
Bariatric surgery remains a successful treatment for obesity and several related diseases. And these days, the latest trend has been an increase in the laparoscopic sleeve gastrectomy pro-cedure over the gastric bypass.

“We’re able to do the laparoscopic sleeve gastrectomy with fewer incisions and there- fore less post-operative pain and less risk of infection,” says Dr. Louis Balsama of Advocare Surgical Specialists of Washington Township, who was the first surgeon in our region to perform a single incision lap sleeve gastrectomy.

During the procedure, about 75 percent of the stomach is removed, leaving a narrow gastric tube or “sleeve.” No intestines are removed or bypassed during this procedure and it’s proven to be a safe and effective surgery to help obese patients lose weight.

There’s no doubt the options for patients looking to lose weight continue to improve. In 2015, the FDA approved a non-surgical weight loss device called a gastric balloon. Balsama says this is a viable alternative for patients who do not meet the requirements of bariatric surgery. The bal-loon is inserted into the stomach using an endoscope and is then inflated. By taking up room it limits how much food a person can eat. As the science continues to find new and improved solu-tions, the hope is that the obesity epidemic will finally be tamed.

There have been a number of new advances in the field of fertility medicine. Among these have been the freezing of one’s eggs. Women may choose to freeze their eggs for a variety of reasons including the extension of their childbearing years because they aren’t ready for kids or because of medical concerns, such as cancer treatment, says Dr. Louis R. Manara, medical direc-tor of the Center for Reproductive Medicine and Fertility in Voorhees.

“One of the things we never want to do is interfere with a patient’s cancer treatment,” Manara says. “Our greater understanding of how to freeze eggs—and do so with a good survivability—has allowed us to keep things moving forward for our patients.”

Another new advance is egg rejuvenation—that is, the idea of “freshening up” a woman’s aging eggs.

“Recently published research has suggested that eggs of older women with proven poor egg quality may be ‘rejuvenated’ through a technique that is being pioneered in Canada and Europe,” Manara says. “The technique involves extraction of tissue from the outer layer of the patient’s ovary and utilization of tissue culture techniques to isolate healthy precursor cells that contain healthy mitochondria. These mitochondria can be extracted and injected into the cytoplasm of the egg during a traditional IVF treatment cycle, improving the prospects that the egg will ferti-lize normally and become a healthy embryo. This technique is still undergoing rigorous trials and research but seems to hold some promise for the not-too-distant future.”

Published (and copyrighted) in South Jersey Magazine, Volume 13, Issue 14 (July, 2016).
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