Advanced Robotic and Laparoscopic Procedures with Excellent Patient Care
Dr. Amit Kharod is the Chief of Surgery at CentraState Medical Center. A general surgeon, board-certified in general and laparoscopic surgery, he specializes in gallbladder removals, laparoscopic hernia repairs, complex abdominal wall construction surgery, and breast surgery. He is the founder of Advanced Surgical Health Associates (ASHA), and with physicians Dr. Thomas Kayal and Dr. Michael Menack, the practice offers a wide array of robotic and laparoscopic procedures with excellent patient care.
What are some of the most common procedures you perform?
Some of the most common procedures we perform are gallbladder removal and hernia repair. The difference with our practice is that all of our surgeons have undergone advanced training to perform many different procedures laparoscopically using state-of-the-art tools and technology, such as robotics. A very small group of surgeons in the country have received special training to perform this surgery.
As a surgeon, it allows you the control, range of motion, and visibility of open surgery, while simultaneously allowing you to get precise results within a very small space at different and sometimes difficult angles. This type of precision usually translates into significantly less pain and faster recovery for you.
What type of robotic-assisted surgery do you offer for gallbladder removals?
I perform cholecystectomy (gallbladder removal) by using the Single-Site™ instruments on the da Vinci® Si™ Surgical System. The da Vinci System features a magnified 3D high-definition vision system and fl exible single-site instrument which enable me to operate with enhanced vision and precision. By using this system, I can remove your gallbladder through one tiny incision in the belly button, making the procedure virtually scarless.
What type of hernia surgeries do you perform?
Mostly ventral and hiatal hernias. Ventral hernias cause a bulge or lump in the abdomen, which increases in size over time. Unlike a ventral hernia, a hiatal hernia is located in the diaphragm. It doesn’t have any symptoms you can see, but can cause heartburn and gastroesophageal reflux disease (GERD). Both hernias can be repaired by minimally-invasive surgery. To repair a ventral hernia, we make a few small incisions in your abdomen using long, thin surgical instruments and a small camera that guides the surgeon.
A hiatal hernia can be fixed through a minimally-invasive procedure called Transoral Incisionless Fundoplication (TIF), which corrects GERD by creating a valve mechanism at the bottom of the lower esophageal sphincter. TIF is performed under general anesthesia and most patients return to work within a few days.
Do you have any recommendations on how patients should choose a surgeon?
Even straightforward surgeries can result in complications, so make sure you choose your surgeon carefully. Research providers by asking your social network, as well as medical office and hospital based nurses for recommendations, and make sure you choose a quality surgeon with whom you feel comfortable entrusting your life.
Don’t hesitate to ask a surgeon for patient references. You want to make sure that the surgeon you choose is regularly performing the operation you need with consistently successful outcomes.
What are some other surgical procedures that patients are getting in your office?
We also provide conservative surgical options for the bowel, liver, appendix, thyroid & parathyroid, veins, and hemorrhoid treatment. In addition, we offer testing for chronic constipation, fecal incontinence, and esophageal reflux. At ASHA, we will work with you to figure out the best plan of action for your health.
Atlantic NeuroSurgical Specialists
3700 Route 33, Suite B Neptune, NJ 07753
(732) 455-8225 www.ansdocs.com
Atlantic NeuroSurgical Specialists
Managing Back Pain
Dr. Pinakin R. Jethwa is a native of Wayne, NJ. He completed medical school and neurosurgical residency training at Rutgers New Jersey Medical School, where he learned to treat the full spectrum of patients with brain and spine disease. He is board-certified in neurosurgery and is one of the few surgeons in New Jersey who performs both complex and minimally invasive spine surgery. Dr. Jethwa has published extensively on various topics within neurosurgery, including spine surgery, vascular diseases, brain tumors, and cost-effectiveness in neurosurgery.
What are some of the recent innovations in back surgery?
There have been notable advances in minimally invasive techniques for spine surgery, an advance that represents a tremendous improvement over traditional or “open” spine surgery. Now we can treat spinal disorders surgically with smaller incisions, less pain, and less blood loss, ultimately leading to better outcomes in the long run for the patient.
The other big improvement is in much better patient selection. Not every patient who comes into the office with back pain needs to have a spinal operation or spinal fusion done. Many can be managed non-operatively, and outcomes are better because we are able to identify patients for whom medical or non-surgical treatment is more appropriate.
Has there been a learning curve for treating back pain?
Only 15 to 20 years ago, almost everyone was getting a large back operation to fuse parts of the spine together. In those days, this was major surgery involving a lot of pain, blood loss, and long post-operative recovery times. Now we’ve learned that many patients will benefit just as much from less invasive surgery.
Depending on the source of the pain, some patients may only need a simpler operation to take pressure off the nerves. In other cases, there may be degenerated or slipping discs, or compression of the spinal cord, needing a more complex operation.
However, with minimally invasive techniques available to us today, we can do even more complex operations through smaller incisions with less blood loss and much shorter recovery periods.
What is sciatica?
Sciatica is a blanket term for pain that goes down the back of the legs. That pain can be due to compression of the sciatic nerve either at the level of the spine, at the level of the nerve root where the nerve exits the spine, or in the muscle itself.
Most commonly that pain is due to a problem in the lower spine, but it can be from somewhere else, which is why it is best to consult a surgeon who will identify the source of the pain and recommend the appropriate treatment. Rule #1 in neurosurgery is to try to locate where the problem is before deciding on treatment.
What are some considerations for patients when choosing a neurosurgeon?
Important considerations include competency, training, experience, and extent of follow up. It’s your body, your life, and you have a right to ask about a surgeon’s rate of complications for a procedure. No surgeon will have zero complications, but the main thing you want from your surgeon is honesty.
You should feel that that the doctor is upfront with you about what is wrong and what needs to be done, and what you can expect during the overall process from beginning to end.
What will happen in the hospital, who will I see, what kind of postoperative care, how long physical therapy, and what about follow up appointments?
Doctors who give you their time are the ones you want to stick with. You should be able to have all your questions answered. Free communication between doctor and patient is what makes for a relationship built on trust.
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What are Bioidentical Hormones, and how do they compare to the hormones used in traditional Hormone Replacement Therapy?
In 2002, the FDA placed a black box warning on traditional Hormone Replacement products because they may lead to cancer. That is when women seeking relief from menopausal symptoms and their physicians turned to something else: Bioidentical Hormones. Previously all that was available were synthetic hormones. Bioidentical Hormones come from plants and are identical to hormones already produced in the human body.
In 2006, actress Suzanne Somers wrote a whole book on Bioidentical Hormones (Ageless – The Naked Truth about Bioidentical Hormones). She called them “the Youth Hormones” and ever since, people have gotten more and more interested in Bioidentical Hormones, particularly as anti-aging medicine. It has grown into a 190 billion dollar-per-year industry.
What are their benefits and uses?
A woman’s body changes over time and so do the requirements of her body. Some of those changes may even be responsible for problems that are attributed to other things, and can respond to Hormone Replacement Therapy using Bioidentical Hormones (BHRT).
Bioidentical Hormones are most commonly prescribed for menopausal symptoms, such as hot flashes, sleep disturbance, weight gain and decreased libido. They have other benefits and uses as well. For instance, the treatment of polycystic ovaries, pre-menopausal symptoms, sexual dysfunction, and to support the health of the ovaries.
For women going through menopause, some Bioidentical Hormones may reduce the risk of heart disease or improve symptoms of Alzheimer’s disease. And there is some evidence that Bioidentical Hormones used after menopause can keep the body younger.
Are they safe?
Because Bioidentical Hormones are so similar to the hormones already in the human body and because they are made from plants, not synthetic hormones, they don’t have the same safety issues as standard Hormone Replacement Products. Side effects are rare. (I have not seen any myself). Still, patients dealing with breast cancer are usually excluded from receiving them.
FDA-approved Bioidentical Hormones, including estrone sulfate, estropipate, estradiol and progesterone, have been proven both safe and effective. Several others are in the pipeline, with clinical trials supporting evidence that they, too, are beneficial.
Custom preparations, designed to fit a particular patient’s hormone replacement needs, cannot be individually studied and approved by the FDA. However, they are created by compounding pharmacies that operate under FDA guidelines.
How does a woman go about getting BHRT? Who should she consult? What can she expect?
Start by getting the facts. There is so much in the media and on the internet, different pros and cons as well as claims made online that can be exaggerated or inaccurate. People need to be more educated.
Work with a doctor who specializes in Bioidentical Hormone treatments and who is certified in prescribing these medications – one who has trained with the American Academy of Anti-Aging Medicine, for instance, or who is a fellow of the Metabolic Medical Institute.
Expect to have a saliva test to assess hormone levels and determine which bioidentical hormones to add to the body. Accurate interpretation of test results is important – and another reason to work with a qualified physician.
Dr. A. Michael Abboud, founder of The Total Women’s Wellness Center, is an Obstetrician Gynecologist dedicated to “keeping women happy and healthy throughout their lifetime.” He has served women and their families for more than two decades, providing compassionate and technologically up-to-date medical care of the highest quality. At locations in Staten Island and Brooklyn, he and his staff offer medical spa services, wellness programs and anti-aging medicine, along with a full range of obstetric and gynecologic services.
Dr. Abboud is affiliated with the New York – Richmond County Medical Center and the New York Medical Society. He is a Fellow at the Metabolic Medical Institute and a Fellow at the International Laparoscopic Society. He is fluent in English, Arabic, Russian and Ukrainian.
Pediatric Orthopedic Surgery Program
Dr. Bipin Patel has been chairman of pediatric services at The Children’s Hospital at Saint Peter’s University Hospital for more than 25 years, building one of the largest and most highly regarded children’s hospitals in New Jersey. He also served as medical director of the New Jersey Institute of Disabilities, developed the Dorothy B. Hersh Regional Child Protection Center in New Brunswick, and led the creation of the Saint Peter’s Regional Craniofacial-Neurosurgical Center. Additionally, his humanitarian efforts help improve children’s health in a host of other countries.
Saint Peter’s is renowned in New Jersey for its maternal fetal medicine and pediatric medicine programs. Are there any new offerings at Saint Peter’s for families with children?
Nearly 6,000 new babies begin their lives at Saint Peter’s University Hospital each year – more than at any other hospital in central New Jersey – and many of them continue to receive whatever medical care they may need throughout childhood. The hospital, however, was lacking in one service—until recently. This October, it launched its new pediatric orthopedic surgical program at the Children’s Hospital at Saint Peter’s University Hospital. Saint Peter’s wants to offer patients 24/7 care for their pediatric orthopedic injuries and problems. A tremendous number of children come in and out of the hospital, and it was time to take a serious look at this and develop this division within our department. This service was really needed. We are very happy to provide this service to our patients and we can service area community hospitals that do not have these services as well.
How did the pediatric orthopedic surgery program get started?
To launch the program, the hospital hired two newly minted pediatric orthopedic surgery specialists — Alexandra Kondratyeva, D.O., who completed her fellowship at Columbia University Medical Center, and Amie Kawashima, D.O., who was a fellow at Shiner’s Hospital and St. Christopher’s Hospital for Children in Philadelphia. Only about 30 to 40 doctors earn pediatric orthopedic surgical fellowships a year. Saint Peter’s is fortunate to have both Alexandra and Amie.
What sorts of services does the pediatric orthopedic surgery program provide for patients?
The surgeons treat all types of issues, including birth defects and deformities, traumatic injuries and spinal conditions such as scoliosis. They are well trained in the full breadth of care and perform all types of surgeries. Dr. Kondratyeva tells us it is very rewarding working with kids. She explains that she can treat a variety of conditions and she can follow up with them from birth through age 20; she couldn’t do that in any other specialty. Dr. Kawashima says she likes caring for children because she never knows what they are going to say. Treatments for children are different than for adults, she adds, so she believes it is important to keep parents well-informed about their children’s care.
What is in the program’s future?
The program will continue to grow over the next 6 to 12 months and there is the desire to hire another pediatric orthopedic surgeon in 2017. The program was added to reinforce Saint Peter’s ability to provide 100 percent care for all pediatric problems for the community.
What other sorts of pediatric surgical services does Saint Peter’s offer?
The Children’s Hospital at Saint Peter’s provides comprehensive general and specialized surgical care to treat congenital and acquired conditions affecting children from birth through young adulthood. Our specially trained staff is experienced in treating common pediatric ailments such as appendicitis and hernias as well as rare or complex conditions.
Delco Drugs & Specialty Pharmacy
3833 Richmond Avenue
Staten Island, NY 10312 (718) 227-9800
Instead of a spoonful of sugar to help your medicine go down smoothly, stop by Staten Island’s very own apothecary, Delco Drugs & Specialty Pharmacy. There, modern day licensed pharmacists, like owner Robert Annicharico and his staff, use innovative technology to create custom-made medications for a wide variety of individual needs that mass-produced pharmaceuticals cannot accommodate.
At Delco Drugs & Specialty Pharmacy, the personalized preparation of medications and other types of treatments for pain, hormone replacement, and anti-aging skin therapies harkens back to the pharmaceutical industry’s roots. In their compounding facility, artisanal medications are crafted with distinctive quality ingredients combined perfectly to form the right strength and dosage for each individual patient.
“We are the direct opposite of the commercial drug store,” says Robert, “because we serve the unique needs of our patients.” Some patients depend upon delicate adjustments of strength or dosage to ensure the medication is effective. Others, like toddlers, benefit from flavored medications to make them more palatable.
Patients with certain allergies require reformulated pharmaceuticals that eliminate non-essential ingredients like gluten or dye. “It is in our lab that we can alter a medications form,” Robert says. “For example, from pill to gummy bear to help individuals who have difficulty swallowing medications.”
No longer do area pet owners have to trick their beloved companions into taking their meds. Delco Drugs & Specialty Pharmacy also provides veterinary compounding services that transform your pet’s medications into “paw licking” good treats that will leave your dog’s tail wagging, your cat purring or your bird chipping! At Delco Drugs & Specialty Pharmacy, it’s not all chemistry. The store provides a large selection of health-related items as well as non-pharmaceutical goods, in an effort to offer a truly customized pharmacy experience to residents of Staten Island and neighboring New Jersey towns.
RED BANK, NJ – On Tuesday, November 29, guests joined the executive leadership of Immediate Care Walk-In Management, physicians and clinical staff, along with state and local officials for the ribbon cutting ceremony of Immediate Care Walk-In of Red Bank. The urgent care center, which opened on October 19, is located at 46 Newman Springs Road East in Red Bank, and is the company’s fourth urgent care center.
Welcoming remarks were delivered by Immediate Care Medical Walk-In Management CEO, Salvatore F. Cannizzaro, followed by the center’s Director of Medical Services, Dr. Mary Ann Yehl. After the ribbon cutting, staff members provided guided tours of the medical facilities Some of the many public officials in attendance included Senator Joseph Kyrillos, Red Bank Mayor Pasquale Menna, Fair Haven Mayor Ben Lucarelli, Assemblyman Declan O’Scanlon, Red Bank Councilman Edward Zipprich and Monmouth County Freeholder Serena DiMaso. The recently renovated building also houses Immediate Care’s new corporate offices, which guests also toured during the event.
Committed to providing convenient and cost-effective, quality medical services, Immediate Care offers walk-in treatment of non-life threatening illnesses and injuries and provide wellness services such as pre-employment, sports and camp physicals, occupational health services and vaccinations/immunizations. The center is staffed by physicians and nurse practitioners, is also equipped with x-ray and phlebotomy services. For a full list of healthcare services provided, visit www.immcare.com
Hours of Operation:
Monday – Friday 8:00 am – 8:00 pm
Saturday & Sunday 8:00 am – 4:00 pm