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MER153_WebStory_1.pngMercy physicians making history, putting patients first

When George Johnson met with Paul A. Jones, M.D., chief of Cardiovascular Services at Mercy, he was seeking a second opinion as much as he was seeking a second chance. Approximately four years ago, Johnson, 82, had a stent placed in one of his major arteries to repair a large aneurysm. Unfortunately, it was recently discovered that the stent had moved and the aneurysm was expanding. His only option, another large and well-knownuniversity hospital told him, was open surgery. The surgery, however, had a 14% risk of death.

At his daughter's urging, Johnson sought the counsel of Dr. Jones. After examining Johnson's medical records and history, Dr. Jones grabbed a piece of paper and drew a sketch of how he could repair the stent with a groundbreaking, minimally invasive alternative to traditional surgery.

"The fact that he took the time to think about the situation and come up with a new solution was one thing, but the way he very carefully explained everything and made it so specific to my dad was what really made the difference," says Johnson's daughter, Elizabeth Nelson.

This combination of leading-edge yet highly personalized care is unique to Mercy, thanks to Dr. Jones and other forward-thinking physicians like Rami E. Lutfi, M.D., a board-certified surgeon with fellowship training in minimally invasive weight-loss surgery and medical director of the Mercy Lap-BAND program. While Dr. Jones is advancing minimally invasive cardiac and endovascular (inside the arteries) procedures, Dr. Lutfi is pioneering single-incision surgery that leaves patients with no visible scar.

"For a hospital of our size, we're really doing miracles," Dr. Lutfi says. "There's no one ahead of us when it comes to sophisticated procedures. But it's not just about being leading edge; we have the patients' best interests at heart, and they feel very secure here."

Creative Solutions
The procedure that Dr. Jones performed on Johnson was to repair the abdominal aortic aneurysm, utilizing a "snorkeling technique."Johnson previously had a stent graft placed in the artery to reinforce the artery wall and lessen pressure on the aneurysm. But the stent had slipped and was no longer sealing off the aneurysm. Without repair, Johnson faced a ruptured aneurysm and sudden death. Prior to seeing Dr. Jones, the only treatment option he was given by the university hospital was conventional suergery which carried a 14% risk of death.

In the snorkeling procedure, Dr. Jones made a small puncture in the groin and thread catheters up to the location of the aneurysm. Then and extended the original stent, and also placed stents in the renal arteries to ensure blood flow to the kidneys was not compromised. Only a few hospitals in the country have attempted the procedure and Mercy is the only one in Illinois. "Technically, it's very challenging because of the location of the stent graft and the risk of damaging other organs like the kidneys and intestines," Dr. Jones explains.

Dr. Jones successfully performed the procedure last November. By March, Johnson was back at his winter home in Arizona, hoping to get back to his golf game and life as normal. Nelson says both she and her father are grateful to Dr. Jones for his pioneering vision.

But Dr. Jones thinks such creative thinking should be the norm, not the exception. "I think we as physicians need to think about what tools we have and how we can get creative with those tools to offer the patient alternative treatment-options that could work just as well, but be much less risky," he says.

New Advances
MER181_WebStory_1-2.pngThat is exactly what Dr. Lutfi is doing with the latest in minimally invasive surgery. In traditional laparoscopic surgery, physicians make several small incisions and insert tiny instruments and a camera. With single-site surgery, Dr. Lutfi makes one, 1/2-inchincision deep in the patient's bellybutton. A sophisticated new port with multiple openings allows him to insert all the tools he needs through that single incision. The patient is left with no visible scar and recovery times are expected to be faster.

Dr. Lutfi has performed Lap-BAND weight-loss surgery, gall bladder surgery, hiatal hernia repair and pancreatic surgery through a single incision. He has traveled around the world training other surgeons in technique and tools. He sees it being used with more surgeries over time. "It's challenging, but exciting," he says. "I foresee any operation that can be done laparoscopically could also be done through one incision," he says.

The benefit of no visible scar is especially appealing to weight-loss patients, Dr. Lutfi says. Mercy features one of the region's leading Lap-BAND programs and performs more Lap-BAND procedures than any other hospital in Chicago. Tiffany Madson, 27, underwent minimally invasive Lap-BAND surgery with Dr. Lutfi 18 months ago. She's lost 100 pounds and gone from a 3X dress size to a medium. Madson appreciated the fast recovery of minimally invasive surgery; but is especially grateful for the personalized care she received.

"That night in the hospital, everyone came to visit me and answered all my questions," she says. "Even today, I can call and ask questions any time."

While Dr. Lutfi's work with single-site surgery is at the leading edge of medicine, Mercy's goal is not simply to be first, he and Dr. Jones stress. "We don't do these things just because we can," Dr. Jones says. "We do them because we should and our patients deserve them."

Learn more about the Mercy Heart and Vascular Center
Learn more about the Mercy Lap-band Program



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