Medical Breakthroughs 2009
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Medical Breakthroughs 2009 

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November 2009

Urinary Incontinence In Women Single-Incision Mesh For Minimally Invasive Repair
Sentara urology specialists are using a small surgical incision and a polypropylene mesh sling to support internal structures and restore continence for women (and men).

Urinary incontinence, the accidental leakage of urine, is not an easy topic to talk about. For the millions of women who are limiting their daily activities because of incontinence, it’s a discussion well-worth having.1

Pregnancy, childbirth, trauma, prior surgery, certain medical conditions and even hormonal changes can weaken bladder and urethra muscles and cause them to slip from their normal position. The mesh sling supports the weakened muscles and restores the ability to work properly and prevent urine leakage.

Short Outpatient Procedure
Under a local anesthesia, the mesh sling is placed through a small incision in the vagina and placed under the urethra to provide support to the surrounding muscles. Self-fixating tips are attached to the muscle around the urethra to hold the mesh in place, without any suturing.

Most women are continent and return home just a few hours after surgery. Some activity restrictions allow time for the mesh tips to develop a firm attachment to the muscle.

Pelvic Prolapse
Frequently women will have pelvic prolapse in addition to urinary incontinence. Often the surgeon is able to repair both issues during the same procedure, using a slightly different mesh for pelvic prolapse that is placed between the bladder and anterior wall of the vagina to provide support.

There are different types and causes of urinary incontinence and surgery is only one of many treatment options. Talk to your doctor, visit or call 1-800-SENTARA.



September 2009

Skin Cancers Treated With High Dose Radiation
People with certain types of skin cancers have a new radiation treatment option in their battle against this disease. A mobile high dose rate Iridium device (HDR unit) is used at Sentara Obici Hospital making it easier for patients to receive this service.

Continuous overexposure to the sun creates harmful UV (ultra-violet) rays that can damage skin cells. This results in skin cancers being the most common type of cancer in the United States.* Frequently, skin cancers are diagnosed as “basal cell” or “squamous cell” but there is a third type called “melanomas.” Treatment options for treating skin cancers vary widely and may include surgery, cryosurgery (“freezing”), chemotherapy and radiation therapy.

During radiation therapy, high-energy photons (X-rays) are used to destroy tissue. By using specially-designed applicators in conjunction with the high-dose rate iridium devices (HDR), radiation oncologists can deliver high-dose radiation treatments directly to the skin cancer. This applicator allows more precise treatment to curved or irregular surfaces, including those on the face, arms and legs, while sparing surrounding healthy tissue.

When a patient has multiple skin lesions in one area or surgery is too risky or disfiguring, radiation therapy may be a good path of treatment. Radiation therapy may also be combined with another treatment option in order to increase the chances of curing skin cancer. Protect yourself from the sun with sunscreen and shade and talk with your physician about any suspicious looking areas on your skin.

-Cancer Network accredited. Virginia’s first Network Cancer Program accreditation from the American College of Surgeons’ Commission on Cancer was recently awarded to Sentara. The network currently includes Sentara Norfolk General Hospital, Sentara CarePlex Hospital, Sentara Virginia Beach General Hospital and Sentara Williamsburg Regional Medical Center .

*Center for Disease Control and Prevention

July 2009

People With “Foot Drop” Improving Mobility Through Functional Electrical Stimulation
Physical therapists at Sentara Williamsburg Regional Medical Center will soon be using a technologically advanced functional electrical stimulation foot drop system to help patients with partial leg paralysis to improve their ability to walk. Through the generosity of Sentara Williamsburg Regional Medical Center Auxiliary, the NESS L300™ Foot Drop System will soon be available for the first time to all patients in Hampton Roads.

Mobility, sometimes just the simple act of taking a step, can be challenging for people recovering from a stroke, traumatic brain injury, multiple sclerosis, cerebral palsy or incomplete spinal cord injury. Often, the partial leg paralysis of these conditions prevents the foot from lifting properly to walk. Referred to as “foot drop,” it can cause instability, making walking difficult and limiting function and independence.

Using the latest in wireless technology, the NESS L300™ Foot Drop System is designed to lift the foot during the swing phase of walking. The Foot Drop System is intended to increase speed and stability, offering people with foot drop more freedom to participate in everyday activities.

Here’s how it works. When the gait sensor detects “heel off,” it sends a message to the left cuff that then electrically stimulates the left muscles to lift the foot. This chain reaction of events results in patients achieving a more normal walk (gait).

Physical therapists help patients to reduce pain and improve or restore mobility in ways that enhance a patient’s health and quality of life. Their role is critical in working to educate and coach patients with foot drop in this type of mobility therapy.

-The system has three components: a gait sensor worn in the shoe; a wireless stimulating leg cuff worn just below the knee; and a control unit that is uniquely programmed by the physical therapist.

-The American Physical Therapy Association recently issued their endorsement of this system after a thorough assessment of the system and the clinical study results.

For more information on this treatment, visit


May 2009

Live 3D Transesophageal Echo: Real-Time Views of the Beating Heart Valve

Using the cutting-edge imaging technology of Live 3D TEE, physicians at Sentara Heart Hospital are getting a real-time look at how a heart valve is functioning and making a precise surgical plan, before the first incision is even made.

The more information you have, the better you can plan. That's the basis for the Live 3D TEE technology that provides cardiologists, cardiac surgeons and cardiac anesthesiologists multiple views of the complete mitral valve, in action.

The technology is comparable to a surgical "GPS" -- providing accurate information to make the surgical plan before the surgery begins and visually identifying any revisions to be made, before the surgery is complete.

The mitral valve is the gatekeeper between the left atrium and the left ventricle. Consisting of two triangular flaps attached to a fibrous ring and the ventricular walls of the heart, its job is to prevent the blood in the ventricle from backing up into the atrium. When it's not working properly, surgeons need to find out exactly where the malfunction is occurring.

With Live 3D TEE, cardiac anesthesiologists can see "real-time" views of the complete heart valve while the heart is beating. As a result, a comprehensive surgical plan is established before the first incision is even made. When the operation is finished, a final analysis can confirm if the problem with the heart valve has been resolved. If needed, additional refinements can be done right then, optimizing the results for the patient.

For more information, visit Sentara Heart Services.

March 2009

CyberKnife® Radiosurgery System a Non-Invasive Alternative to Surgery
The highly accurate, non-invasive CyberKnife® Robotic Radiosurgery System now available at the Sentara Advanced Radiosurgery Center at Norfolk General Hospital is offering cancer patients a new option. This technology, combined with the multidisciplinary team approach of the Sentara Cancer Network, provides the most advanced system of its kind in Hampton Roads.

It's not a new surgical technique. It's not done in an operating room. Even with names like "knife" and "surgery," it's really not surgery at all. It is a new non-surgical, radiation procedure for treating cancer that brings the future of medicine to our patients today.

The CyberKnife® system can be used to treat a broad range of cancers and non-cancerous conditions of the head, neck, brain, spine, lung, liver, pancreas, kidney and bone.

During the CyberKnife® procedure, the tumor is essentially covered with radiation, delivering the treatment precisely to the tumor and sparing surrounding healthy tissue. Unlike other forms of radiosurgery such as Gamma Knife, CyberKnife® does not require uncomfortable, rigid head frames to minimize patient movement.

The sophisticated image-guided software tracks and continually adjusts treatment to compensate for any movement by the patient or tumor. This allows patients to breathe normally and relax comfortably during the radiation treatment.

In addition to being highly accurate, the CyberKnife® offers many other patient benefits:

 - Pain-free, non-invasive (no surgical incision) and no anesthesia required.

- Outpatient procedure with no recovery time and immediate return to normal activities.

- No breath-holding required during the procedure and no invasive head or body frame.

The CyberKnife® system is available at the Sentara Radiosurgery Center at Norfolk General Hospital.

January 2009

Dedicated Extremity MRI System Scanning Only the Injured Part of the Body

The MSK Extreme®, an extremity MRI, is the latest innovation in digital imaging that allows patients to recline in a comfortable chair while only the injured part of the body is scanned. This technology is available at the Advanced Imaging Center - Leigh.

It may look like a home recliner or a dentist's chair, but the MSK Extreme®, the latest in digital imaging of the extremities (arms and legs), is the perfect combination of both patient comfort and image quality.

Extreme Comfort
Physicians use the powerful images provided by MRI (magnet resonance imaging) to aid in diagnosing and treating patients' injuries or diseases. With the smaller bore (opening) of the MSK Extreme®, only the injured arm or leg needs to be placed inside the tube to produce powerful high-definition images of the hands, fingers, elbows, wrists, knees, feet and ankles.

The MSK Extreme® is especially helpful for imaging extremities of people with claustrophobia, obesity, or an adult/child who has difficulty holding still. It can even eliminate the need for sedation which is sometimes used to relax patients before entering the full body "tube" of traditional MRI units.

High Quality Imaging
With an average scan time of just 30 minutes, the MSK Extreme® is also quicker and quieter than a full-body MRI. During the scan, the patient is comfortably reclining with Cinema Vision available for TV, DVD or radio entertainment.

Specialized Readings
Adding to the quality of this equipment are the subspecialized musculoskeletal radiologists who expertly interpret the extremity MRI studies.

When you need advanced imaging services, talk to your doctor or visit one of the Advanced Imaging Centers convenient for you.

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