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Carroll County Times
Carroll County

Carroll doctors trying new techniques, technologies

Their specialties may be different, but several local doctors shared a common bond this year.
Each began performing a common surgery with a new twist. They used new medical technologies - ones that hadn't been used in Carroll beforehand but have the Food and Drug Administration's stamp of approval - to likely provide the patient with a better outcome.
Dr. Wayne Barber and Dr. Robert Friedman, both of the Carroll County Surgery Center and the Center for Total Eye Care in Westminster, now use a laser to perform cataract surgeries. It's a procedure most common in older individuals, when driving at night becomes hard, when reading is rendered nearly impossible due to the clouding of the eye.
Dr. John Steers, a Carroll Hospital Center surgeon, is performing single-site hernia repairs. This means there's only one incision used to fix the hernia. The hospital is just one of several using this technique across the country to fix hernias.

Hernia repairs
More than one million hernia repairs are completed each year in the United States, according to the FDA, causing people to lose days from work, especially those whose job involves manual labor.
A defect in the muscle wall, generally in the groin area, prompts the need for a hernia to be repaired because it is painful every time a person stands up or even coughs, said Steers, the hospital's director of minimally invasive general surgery and the vice chief of general surgery.
A hernia is when an organ, fatty tissue or intestine goes through a hole in a nearby muscle or connective tissue, according to the Food and Drug Administration.
Steers is the only Carroll Hospital Center surgeon who performs hernia repairs using one, small incision. With the single site technique, just one incision - about an inch to 1.5 inches in length - is made around the bottom part of the belly button. It could mean less pain and a better cosmetic result.
The single-site method has been around nationally for about five or six years, but it was previously mostly just used for gallbladder surgeries.
Many hernia repairs are performed by making a large incision in the groin that is 3 or 4 inches in length. It takes about six weeks to return to work after such a procedure, according to Steers. Another more advanced, minimally invasive method uses three small incisions about the size of a dime.
However, Steers is one of the first hospital surgeons nationwide to do just one, small incision.
At a Society of American Gastrointestinal and Endoscopic Surgeons national meeting, a company that manufacturers the single-incision device, called a GelPoint Mini, pinpointed Steers to be one of the first to perform the surgery with just one incision.
The hospital has performed about 40 such procedures since April, and the patients are typically back to work within two weeks. With two fewer incisions, the pain is less, and the cosmetic result is better, too, according to Steers.
"We've used them many times and patients seem to love it," Steers said. "They have very little discomfort when the surgery is over."
And that was true for Joe Lambert, of Taneytown. He's had two hernias repaired, and the first procedure was about a dozen years ago, completed by making the 3- to 4-inch incision.
That time, he was in a lot of pain. It took a while to heal. It was sore.
More than six weeks ago, he had the procedure done for the second time - this time with the new single-site technique. He was back to work within four weeks, and he barely sees a scar.

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Laser cataract surgery
Laser cataract surgery can improve the results and eyesight of patients that have this procedure performed with the new device offered in Carroll, according to Friedman, who is one of two in the county who perform the surgery at Carroll County Surgery Center in Westminster.
"It's significantly more accurate and precise than the manual techniques to reduce astigmatism," Friedman, also of the Center for Total Eye Care, said.
A cataract is the clouding of the lens in the eye, according to the National Eye Institute. As some age, the cataracts become cloudier and can severely affect one's vision. It can become harder to read, more difficult to drive at night.
In a traditional cataract procedure, the surgeon uses a blade to make an incision into the eye. Then, ultrasound technology is used to break apart the lens, and it is removed. An implant lens is then inserted into the eye.
The LenSx Femtosecond laser uses computer-guided technology to make the incisions, meaning they're likely more accurate. It also opens up the lens capsule, which was traditionally done by hand, to get access to the cataract.
Then, using the computer technology, the laser makes cuts into the actual lens, which softens the lens material and lets the lens be removed more efficiently, according to Friedman. The laser also makes incisions to correct for astigmatism. The combined time for all this is about 40 seconds.
Next, the patient and surgeon go back into the operating room to complete the surgery that the laser has started. The incision is opened, the cataract removed and a lens is placed inside the eye, Friedman said.
The center first performed the surgery in June, the first in the Carroll County to do so. It uses a more than $500,000 laser to do so, which a company called Sightpath delivers to the center on scheduled days. They've done about 40 cases combined, and the results have been good, Friedman said.
"Patients have been very excited to be offered a technology that hasn't been available before," Friedman said. "Patients are very particular about their eyes, as we expect them to be."
Anita Woods had the procedure done in her right eye the first day it was available, then again in her left in July.
It was easy, the Glen Rock, Pa., resident said. That day, it felt like there was a bit of sand in her eye. But by the next evening, it was fine.
She had the premium lenses implanted in her eyes. Now, she doesn't need her reading glasses and her vision is 20/20.


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