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“НАШЕ ЖИТТЯ”, КВІТЕНЬ 201 2 WWW. UNWLA.ORG 33 MEDICINE — ON THE CUTTING EDGE by Ihor Magun, MD, FACP The number of new accompli shments in medicine has been not h- ing short of extraordinary. Recent i nnovative technology provides amb i- tious new approaches and technique s as alternatives to current trea t- ment. Here is a sampling of new advances. Abnormal thyroid gr owth issues are a common occurrence in many young women. For the most part, surgical correct ion is the only viable option. This option leaves a visible , permanent scar on the neck. “ Scarless ” thyroidectomies can now be accomplished via an endoscope ut i- lizing two cameras along with three robotic arms inserted into a single armpit incision, eliminating visible scars. Pacemakers have been life savers for many with significant cardiac issues. Ironically , many of the same patients, at some point in their life, require an MRI (e.g. evaluation of a stroke, brai n imaging, or spinal evaluation). Patients with an implanted pacemaker cannot undergo this type of evaluation because of a potential risk of dislodgment or change in technological functioning. Unlike traditional pacemakers, the Revo MRI SureScan can be safely used in MRI procedures. A dditional cardiac innovations include correc - tion of an aortic valve (a major valve in the heart) without the need for an open chest a p- proach (approach that cuts the chest ribs to expose the heart) . The technique is called PAVR — percutaneous aortic valve replacement. Currently , it is limited to those individuals who are deemed inoperable by a cardiothoracic surgeon, but in the near fut ure, the indication w ill be expanded to include high - risk patients. Evaluatio n of the arteries of the heart — cardiac catheterization — util izes the artery found in the groin. A new approach referred to as trans - radial artery approach is now becomi ng an o p- tio n. In this method, the arteries of the heart are evaluated by passing wires through an a r- tery in the wrist. The advantages include a si g- nificant ly lower risk of complications (bleed - ing, especially in women , and possible nerve damage), less discomfort, an d a more rapid r e- covery. There is also a decreased hospital time for patient s . Previous techniques utilizing the groin approach required a four - to six - hour time period of lying on the back prior to di s- charge. Hospital time is probably only half of that wi th the trans radial approach. Breast cancer patients who opt to undergo r e- co nstructive surgery for cosmetic breast cor - rect ion need to receive saline injections every few weeks to promote gradual expansion of the skin and muscle in the chest. This is to allow a space to accommodate a breast implant. These injections can be quite uncomfortable for some women , coupled with an added burden of fr e- qu ent hospital visits over a four - to six - month period. A new needle - free tissue ex pansion m e- thod eliminates injections and frequent hospi t- al visits . The new technique utilizes a small implantable expander device. Once the patient is at home, a remote - contr ol device releases small amounts of compressed carbon dioxide from a valve in the actua l expander. A recent study of th e device in Australia reported cre a- tion of a space in as little as fifteen days. This compared equally to spaces created after se v- eral m onths of saline injections. The benefit of this system is placing the patient in charge, at home, controlling the expansion at her own pace and comfort level. This is just a small sampling of innova - tions that can be life - altering and life - saving for man y. Hopefully, none of us would have to resort to these procedures. Nevertheless, I hope I have empowered you with this information about the new advan ces and options that truly are on the cutting edge of modern medicine.
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