Archive for the ‘Medical Professionals’ Category

Medical Center Proud to Have Six Programs Recognized as Blue Cross Distinction Centers

When you need to make a physician referral, the hospital you select can have a direct impact on the care your patient receives and his or her outcome. To help you with these important decisions, Blue Cross Blue Shield developed the Blue Distinction Centers recognition program to identify hospitals with proven expertise in delivering specialty care.

Research confirms that Blue Distinction Centers and Blue Distinction Centers+ demonstrate better quality and improved outcomes for patients, with lower rates of complications and readmissions than their peers. Blue Distinction Centers+ also are more than 20 percent more cost efficient.

Nebraska Medicine is proud to have six programs representing 21 specialties recognized by this program. Three programs have been recognized as Blue Distinctions Centers+ — Blue Cross’s highest recognition. These are cardiac care, knee and hip replacement and spine surgery. Bariatric surgery, complex and rare cancers and transplant were recognized as Blue Distinction Centers and include these specialty areas: liver cancer, pancreatic cancer, primary brain cancer, esophageal cancer, gastric cancer, head and neck cancer, acute leukemia, primary bone cancer, bladder cancer, rectal cancer, soft tissue sarcomas, thyroid cancer, adult pancreas transplant, pediatric autologous and allogeneic bone transplants, pediatric liver transplant, adult autologous and allogeneic bone marrow and stem cell transplant and adult heart care.Mike-Moulton

Michael Moulton, MD

The selection criteria used to evaluate facilities was developed with input from the medical community and includes general quality and safety metrics, program specific metrics, the know-how and expertise of the medical team, the number of times the hospital has performed the procedure and the hospital’s track record for procedure results.

“This recognition is a significant marker of our experience and expertise and reflects our excellent outcomes in cardiac care as well as our ability to provide quality outcomes at a reasonable cost,” says Michael Moulton, MD, chief of Cardiovascular and Thoracic Surgery at the University of Nebraska Medical Center (UNMC). “We are a very busy heart center that provides outstanding care and participates in ongoing clinical trials and education. These are the types of things that attract top physicians and caregivers to our program and help us excel.”

“To be recognized by a third party and one that has a vested interest is a true indicator of our success,” says William Lydiatt, MD, director of the Head and Neck Surgical Oncology Section at UNMC. “It is very rewarding to be recognized by our peers as having a valuable program. We see large volumes of patients in many specialty areas. This experience allows us to continually improve and provide the highest level of care. It’s also what enables us to treat some of the most complex cases and to do it well.”

“This recognition represents an objective assessment of our ability to provide high-quality and high-level spine care,” says Kenneth Follett, MD, PhD, professor and chief of Neurosurgery at UNMC. “We have a staff of physicians and other health care professionals with a high level of experience and training in dealing with spinal disorders. This includes health care specialists from multiple disciplines all in one location which allows us to provide a full spectrum of spine care from simple to complex in an efficient and cost-effective manner.”

“Receiving this recognition is a result of the experience, skills, depth of expertise and the commitment to high quality care that our staff provides to our patients,” says Kevin L. Garvin, MD, professor and chair of the Department of Orthopaedic Surgery and Rehabilitation at UNMC. “Our clinical faculty are skilled in the prevention, diagnosis and treatment of musculoskeletal disorders, ranging from minor injuries to the most complex surgical procedures, including revision arthroplasty and osteotomies. Our team works diligently every day to make the proper diagnosis and prescribe an appropriate and comprehensive course of treatment.”

Validating this recognition, Nebraska Medicine has been ranked one of America’s best hospitals and the top hospital in the state by the U.S. New & World Report’s 2014-15 Best Hospitals list. The medical center is ranked 36th nationally for its cancer care, 29th for gastroenterology and GI surgery, 29th in nephrology, 31st in neurology and neurosurgery, 41st in pulmonology and 25th in urology. Nebraska Medicine was also high performing in six other specialties, including cardiology and heart surgery, diabetes and endocrinology, ear, nose and throat, geriatrics, gynecology and orthopaedics.

New Strides Gained in Diagnosis and Treatment of Lung Cancer

Rudy Lackner, MD

Important strides are being made in the way we screen, diagnose and treat lung cancer. New screening guidelines, in addition to new diagnostic and treatment techniques, are helping doctors find lung cancer earlier and treat it more efficiently, says Rudy Lackner, MD, thoracic surgeon at Nebraska Medicine.

Nebraska Medicine not only offers low-dose CT scan lung cancer screenings, but provides a full spectrum of lung cancer care by a team of surgeons, oncologists, radiologists, nurses and others dedicated to the treatment of lung cancer. Studies show that the chance for long-term survival improves when the medical team involved is dedicated to lung cancer treatment.

Lung cancer screening guidelines published in the Journal of National Comprehensive Cancer Network (NCCN) recommend that individuals age 55 to 74 that have smoked a 30-pack history should be screened with low-dose CAT scan. The guidelines were developed after a study sponsored by the National Cancer Institute and published in the New England Journal of Medicine indicated that screening can reduce lung cancer mortality by 20 percent.

“A CAT scan can detect lung cancer nodules in stage IA when the cure rate can be as high as 90 percent or more,” says Dr. Lackner. “With traditional X-rays, approximately 75 percent of lung cancer cases are found in stage III/IV, when cure rates drop to 5 percent and lower.”

“The most challenging aspect of this screening is determining what should be done if nodules are found,” says Dr. Lackner. “This is where our expertise comes into play. We have a long track record of performing lung cancer screenings and treating lung cancer patients.”

“Whether we biopsy the patient will depend on factors such as the size of the nodules and whether the nodules are increasing in size and multiplying,” says Dr. Lackner. “About 50 percent of the population will have lung nodules from exposure to things like fungus or respiratory tract infections, but only 2 percent of these individuals will have cancerous nodules.”

Nebraska Medicine lung cancer team uses a new minimally invasive biopsy technique called electromagnet navigation bronchoscopy – a computer-guided system that allows physicians to take multiple biopsies and determine immediately if they are cancerous. The biopsies are large enough to allow for mutation analysis and the development of customized chemotherapy. This procedure can also be used for pleural dye marking of nodules for surgical wedge resection, placement of fiducial markers for sterotactic radiotherapy and therapeutic insertion of brachytherapy catheters into malignant tissue.

“With this new technique, we can start therapy the very next day as opposed to a week or two later,” says Dr. Lackner. “In the past, we would have to wait for the biopsy results, followed by an outpatient surgery procedure to stage the tumor.” At the time of the diagnosis, Dr. Lackner says they can also perform an endobronchial ultrasound, a procedure that can be performed during the bronchoscopy to stage the lung cancer. “It allows us to view regions of the lungs and surrounding chest area that have traditionally required more invasive surgical procedures to evaluate,” says Dr. Lackner. “If the lymph nodes are negative but the tumor is positive for cancer, we can perform surgery to remove the cancer at the same time. No one else in the area is doing it this way.”

Nebraska Medicine lung cancer team also treats some of the sickest and most complicated patients that other hospitals won’t treat. “Because of our experience and dedicated expertise, we are comfortable treating the elderly as well as high-risk patients who have had other complications like heart disease, lung disease or other medical problems.”

“We’re the only ones in the area who routinely perform surgery on stage III lung cancer patients after chemotherapy and radiation,” he says. “We also have an active program for performing minimally invasive lobectomies and segmentectomies.”

The lung cancer team also includes a certified tobacco treatment specialist who can provide one-on-one smoking cessation counseling. “I tailor the program to the patient’s needs and past experiences,” says Jill Selzle, PA-C, certified tobacco treatment specialist. “Studies show that pharmacological therapy and behavior modification alone are effective, but the combination of counseling and medication provides more effective results.”

Lung cancer is the most common cause of cancer deaths in both men and women in the United States and is the most preventable. It causes more deaths in women than breast, cervical, uterine and ovarian cancers combined. “I am hopeful that this new screening, combined with new diagnostic and treatment techniques will help turn those statistics around,” says Dr. Lackner.

Dr. Lackner works side-by-side with Apar Kishor Ganti, MD, a hematologist/oncologist specializing in lung, head and neck cancers, Karin Trujillo, MD, who with Dr. Lackner, are the only thoracic surgical oncologists in Nebraska with practices limited to cancers of the chest. The other members of his team dedicated to the care of lung cancer patients include oncologists Anne Kessinger, MD and Alissa Marr, MD, radiation oncologist Weining (Ken) Zhen, MD, pathologist William West, MD and radiologist Matthew DeVries, MD.

To learn more, make a referral or connect with a member of Dr. Lackner’s team call 402-559-5600 or visit us online at

Click on the icon below to learn more about upcoming oncology focused CME opportunities.oncology-cme

Drs. Oleynikov, Farritor win Game Changer Award

by Charlie Litton, UNeMed


From left, UNL’s Shane Farritor, Ph.D., and UNMC’s Dmitry Oleynikov, M.D.

A surgical robot developed in collaboration between UNMC professor of surgery Dmitry Oleynikov, M.D., and Shane Farritor, Ph.D., professor of engineering at UNL, was recently named a prestigious Game Changer Award winner by the Robotics Business Review.
The annual Game Changer Awards were officially announced in San Jose, Calif., on Sept. 24, during RoboBusiness, one of the largest international robotics conferences in the United States.

The award-winning robot of Drs. Oleynikov and Farrior is the foundation of a University of Nebraska startup company, Virtual Incision, which recently raised more than $11 million in equity financing.

The two researchers developed a surgical robot that could turn highly invasive surgeries into laparoscopic procedures. The current focus is perfecting the robot’s ability for colon resection, a complicated surgical procedure that removes a damaged or diseased section of a patient’s colon. It’s a treatment for patients with lower gastrointestinal diseases such as diverticulitis, Crohn’s disease, inflammatory bowel disease, or colon cancer.

“We are very excited to be among the group selected for the Game Changer Award,” Dr. Farritor said. “If you look at this group of winners, and at past recipients, it is an amazing honor to be included in this list.”

Entries were judged by a panel of Robotics Business Review and Robotics Trends editors as well as by distinguished experts from the International Journal of Advanced Robotics Systems (IJARS).

In 2014 the University of Nebraska system honored Drs. Oleynikov and Farritor with its prestigious Innovation, Development and Engagement (IDEA) Award.

Nebraska Medicine Earns National Pancreas Foundation Center Designation, 1 of 30 Centers in the U.S.

Only Hospital in Nebraska to Receive the Distinguished Honor

Nebraska Medicine has been nationally recognized as a National Pancreas Foundation Center (NPF) by the National Pancreas Foundation, a nonprofit organization that provides support, research and education for those suffering from pancreatitis and pancreatic cancer. Nebraska Medicine is the only hospital in Nebraska to receive this prominent designation, joining 29 other institutions across the United States.

“Our team is thrilled to be named the only NPF Center in the state of Nebraska,” says Nebraska Medicine pancreatic surgeon Luciano Vargas, MD. “Our pancreas program provides multidisciplinary, patient centered care for patients with different pancreatic disorders. The program has been made possible by a strong commitment and support from Dr. Alan Langnas and the leadership at Nebraska Medicine.”

NPF_LogoNPF Centers are awarded after a rigorous audit review to determine that an institution’s focus is on multidisciplinary treatment of pancreatitis, treating the “whole patient” with a focus on the best possible outcomes and an improved quality of life.

“We are very humbled and proud of this achievement,” says Rosanna Morris, Interim CEO at Nebraska Medicine. “Having the NPF Center designation will help distinguish us as an institution whose focus is on providing the best and most innovative care possible for those suffering from pancreatitis.”

“Once an institution receives this designation, our foundation can recommend with confidence that patients will receive quality care at these designated Centers,” says Matthew Alsante, Executive Director of the National Pancreas Foundation.

An approved NPF Center has to meet the criteria that were developed by a task force made up of invited subject matter experts and patient advocates. The criteria includes having the required expert physician specialties such as gastroenterologists, pancreas surgeons, and interventional radiologists, along with more patient focused programs such as a pain management service, psychosocial support and more.

“It’s an honor for me to work with such a wonderful team of physicians,” says Sarah Ferguson, nurse coordinator for the Pancreas and Biliary Disorders Clinic at Nebraska Medicine. “Their dedication, expertise and compassion towards helping patients with pancreatitis is truly deserving of this national recognition.”

For a full listing of the criteria, please visit

30 Designated National Pancreas Foundation Centers
•Allegheny General Hospital, Allegheny Health Network
•Banner University Medical Center
•Baylor University Medical Center
•Beth Israel Deaconess Medical Center
•Boston Children’s Hospital – Harvard Medical School
•Brigham and Women’s Hospital
•Dartmouth-Hitchcock Medical Center
•Geisinger Medical Center
•Hackensack University Medical Center/John Theurer Cancer Center
•Johns Hopkins Medical Institutions
•Mayo Clinic Florida
•Mayo Clinic Rochester
•Medical University of South Carolina
•Medstar Georgetown University Hospital
•Nebraska Medicine
•New York Presbyterian Hospital/Columbia
•Pancreas Care Center, Cincinnati Children’s Hospital
•Providence Portland Cancer Center
•Saint Louis University/ SLU Care Center for Pancreatic and Biliary Diseases
•Stanford University
•The Ohio State University Wexner Medical Center
•UMass Memorial Medical Center
•University of Alabama at Birmingham
•University of Chicago
•University of Florida/UF Health
•University of Miami, Leonard M. Miller School of Medicine
•University of Michigan
•University of Minnesota
•University of Pittsburgh School of Medicine
•Virginia Mason Medical Center

The Programs That Make Us Great


News and World Reports recently ranked Nebraska Medicine as one of the best hospitals in the country for its expertise in six adult specialties: cancer care, gastroenterology and GI surgery, nephrology, neurology and neurosurgery, pulmonology and urology. This is the best performance for the hospital in terms of national recognition in these rankings.

In a series of blog posts, the experts from each nationally-ranked department will highlight what makes Nebraska Medicine a leader in providing care to its patients.

For the third year, U.S. News & World Reports ranked The Nebraska Medical Center as a “Best Hospital for Pulmonary Care.”

In our pulmonary division, we’ve worked hard to meet our patients’ needs throughout the region—eastern Nebraska, western Iowa, South Dakota, and Kansas. We handle a great deal of general pulmonary care, like chronic obstructive pulmonary disease (COPD), asthma, pulmonary fibrosis, bronchitis, shortness of breath, and cough.

Our national reputation is based on several well-established programs that are vital to treating patients with the most complex pulmonary problems, including:

Joe Sisson, MD

Pulmonary Hypertension Program

Our pulmonary hypertension clinic, under the leadership of Austin Thompson, MD, is known nationally. We diagnose and treat very sick patients who need specialty care for this condition. Pulmonary hypertension (PAH) is shortness of breath during routine activities—caused by increased pressure in arteries that carry blood from your heart to your lungs.

Many people in this region suffer from PAH, and we are the primary regional referral center for these patients. Our nurse case manager works very closely with Dr. Thompson to treat each PAH patient. Also, our PAH patients are often enrolled in clinical trials, which is very important since these trials offer novel treatments to our patients who have not responded to conventional medications.

Adult Cystic Fibrosis Center

Our adult cystic fibrosis (CF) program, led by Peter (Jim) Murphy, MD, is unique in this region, as we handle growing numbers of adult patients. CF patients are living much longer today, thanks to excellent patient care. Now they’re having children of their own—and we can and often treat the whole family. We are a certified Adult CF center and are recognized by the National Cystic Fibrosis Foundation as a high performing benchmark program. In fact, our team travels to other CF centers in the nation to help improve their patient outcomes—in lung health maintenance as well as nutrition.

Critical Care Medicine (CCM)

At The Nebraska Medical Center, our intensive care units (ICU) are staffed with critical care specialists called intensivists. Many of our patients aren’t familiar with that term. Essentially, it means we are specialists in treating critically ill patients in the intensive care unit. Our CCM teams manage life-and-death situations—including talking with anxious patients and their families.

Our Division’s critical care specialists, in partnership with intensivists from anesthesia, lead three CCM teams who work closely with heart surgeons, neuro surgeons, neurologists and other specialists to manage their critically ill patients while they require intensive care. The CCM teams guide the patient’s overall care including supporting lung function with ventilators, administering IV fluids & medications, providing nutrition and getting patients up and walking. This proactive and team-based approach to the care of critically ill patients helps prevent infections, blood clots, pneumonia and other complications. That is why our shared patients have very good outcomes—and a key part of why our hospital ranking is high.

But that’s not all…our allergy, sleep and pulmonary services are growing.


Our well-established allergy program is growing. We have a nationally recognized allergy specialist, Jill Poole, MD, who is an expert at developing region-specific allergy testing and treatments for adults. We will expand our allergy program in the summer of 2015 when a second allergist joins Dr. Poole allowing us to reach more adult and pediatric patients with our allergy clinics.


Our busy sleep laboratories and clinics will soon be more visible in the Omaha community, as we expand our sleep program. Our sleep patients typically suffer from complex problems, and that’s where our sleep medicine experts excel. With our certified sleep laboratory, continued program development, and collaboration with other specialties such as otolaryngology, we are investigating new and innovative solutions for these complex sleep disorders.

Lung Transplantation

We will add lung transplantation to our portfolio in early 2015. This is especially exciting because no other facility in our region can provide this option for their severely ill pulmonary patients. Lung transplantation will be an important new dimension for our other pulmonary programs and will round out the types of organ transplantations offered at The Nebraska Medical Center.

As you can see, our Pulmonary, Critical Care, Sleep and Allergy division is rising in the U.S. News & World Report “Best Hospitals” rankings for good reasons. We’re proud of the progress we’re making.

Hope for Stroke Patients: Recent Treatment Advances Offer Better Chances for Recovery

Stroke is a severely debilitating disease that can permanently change the lives of patients and their families. Everyone knows a family member or a friend whose life has been permanently changed by stroke. Stroke is a very common disease around the world. Every year more than 795,000 people in the United States will suffer a stroke and more than 130,000 will die as a consequence of stroke. In Nebraska, stroke is the fourth leading cause of death and more than 36,000 people live with stroke. Despite these frightening numbers there is hope for stroke patients.

Stroke prevention

The best way to prevent a stroke is to take care of yourself. More than 90% of strokes are the result of poorly controlled medical conditions. Avoid tobacco, control your weight, watch your diet, exercise and follow up regularly with your primary care physician. Work closely with your doctor to control your high blood pressure, diabetes, high cholesterol or heart disease. Just by reducing your blood pressure by 10 points you can decrease your chance of having a stroke by one-third. Controlling the other risk factors will decrease your chances even further.

Sudden signs of stroke: remember them easily with “FAST”

Stroke can present in many different ways: confusion, severe headache, dizziness, double vision, facial droop, difficulty swallowing, arm or leg numbness or weakness, sudden loss of balance, inability to speak and slurred speech all are symptoms of stroke. One easy way to remember the sudden signs of stroke is by using the F.A.S.T. acronym. F is for facial droop, A is for arm weakness, S is for speech difficulties and T is for time to call 9-1-1. If you think you or a loved one is having a stroke, the best course of action is to call 9-1-1. Patients who call 9-1-1 arrive faster to the nearest hospital capable of treating stroke and have better chances of receiving treatment.
Stroke types and treatments

There are two major types of strokes: ischemic and hemorrhagic. Ischemic strokes are by far the most common type in the United States and in Nebraska. An ischemic stroke is usually the result of a blockage in a blood vessel, whereas a hemorrhagic stroke is due to a blood vessel rupture. Treatment is different for each type; however rapid treatment is essential in both.

Since 1996, the only FDA approved treatment for acute ischemic stroke has been to administer alteplase. This is a medication that is given to patients with an ischemic stroke who arrive to the Hospital within 4 ½ hours from the onset of symptoms. Patients who receive this drug have a 33% increased chance of being independent or less disabled at three months after their stroke, when compared with people who did not receive the drug. In the last six months there have been significant advances in the treatment of acute ischemic stroke. Five new studies show that patients who suffered a large stroke and were treated with new devices called stent retrievers – within 6 hours of onset, in an experienced stroke center – have a 33% to 71% percent chance of regaining independence or experiencing less disability at three months.

New, advanced treatment options available at Nebraska Medicine

Nebraska Medicine has the capacity to offer these novel treatments to stroke patients who qualify. We are also working to make these crucial advancements in treatment options available to more people in Nebraska and neighboring states by establishing a telestroke network with hospitals throughout the state. Telestroke brings neurology expertise to bedside of community hospitals. Working together, the neurologist and emergency department physician collaborate on the most appropriate treatment for the stroke patient. This program will provide local emergency rooms with 24- hour access to stroke neurology expertise and the advanced treatment options available at Nebraska Medicine.

‘Raise that beam!’

by John Keenan, UNMC public relations

A Kiewit representative helps Emily Stephenson, 3, and sister Julia, 5, signal for the beam-raising as their mom, Amy Stephenson, looks on with UNMC Chancellor Jeffrey P. Gold, M.D.

“Raise that beam!”

With that cry from 3-year-old Emily Stephenson — echoed by her 5-year-old sister, Julia — the first signed beam was raised to the top of the Fred & Pamela Buffett Cancer Center.

For a photo album of the beam raising, click here.

Emily Stephenson, who her mother said is being treated at Nebraska Medicine for a blood disorder, may have been the tiniest VIP in attendance, but she was as enthusiastic as any of the other cancer center supporters.

See beam signings throughout Nebraska here.

Omaha Mayor Jean Stothert was on hand to extend congratulations on the construction milestone, saying the tower cranes on the Omaha skyline point to “a future of growth.”

See campus leaders discuss the impact of the Fred & Pamela Buffett Cancer Center here.


The signed beam, with the U.S. flag attached, is hoisted to the top of the Fred & Pamela Buffett Cancer Center.

Calling the project “a commitment to save lives,” Mayor Stohert said the Fred & Pamela Buffett Cancer Center will provide important job opportunities before and after the building is completed, adding $500 million to the local economy.

Speaking before the beam-raising, UNMC Chancellor Jeffrey P. Gold, M.D., welcomed faculty, staff, donors and local officials, including Mike Yanney and Gail Walling Yanney, M.D.; Ruth Scott; representatives from the Cattlemen’s Ball; Omaha City Council members Pete Festersen, Chris Jerram and Ben Gray; state Sens. Jim Smith, Merv Riepe, Sue Crawford, Al Davis, Bob Hilkeman, Rick Kolowski and Mark Kolterman; and former U.S. Sen. Ben Nelson and others.

“This is truly a great day for our campus,” Dr. Gold said. “This facility represents how health care will be delivered in the future, and also how our campus will integrate clinical care, discovery and education, all for the benefit of our patients. It’s really an exciting day.”

Ken Cowan, M.D., Ph.D., director of the Fred & Pamela Buffett Cancer Center, pointed out that it would only be 18 more months before the group gathered again for the center’s opening.

signed0812Nebraska Medicine staff and UNMC faculty, staff and students, came out — along with donors, campus and community leaders and other supporters — to sign the beams and see them raised.
“Tremendous progress has been made, and every day we are closer to this state-of-the-art cancer center that will really transform Nebraska, the region and the country,” Dr. Cowan said.

Nebraska Medicine interim CEO Rosanna Morris said that when the Fred & Pamela Buffett Cancer Center opens, “it will have everything our cancer center patients need, all in one place. How do we know? Because we’ve involved physicians, reseachers, staff members and — most importantly — cancer patients in every aspect of the design of the facilities.

“We know, and they know, that curing cancer is not just about eradicating cancer cells,” she said. “It’s about so much more. It’s about treating the whole person – mind, body and spirit.”

Best Hospital for Urology Care – Right Here

U.S. News and World Reports recently ranked Nebraska Medicine as one of the best hospitals in the country for its expertise in six adult specialties: cancer care, gastroenterology and GI surgery, nephrology, neurology and neurosurgery, pulmonology and urology. This is the best performance for the hospital in terms of national recognition in these rankings.

In a series of blog posts, the experts from each nationally-ranked department will highlight what makes Nebraska Medicine a leader in providing care to its patients.

It’s gratifying to see U.S. News & World Reports lists Nebraska Medicine among the best hospitals in the nation for urology. The report ranks us 25th among the 1,570 programs evaluated in our specialty.

Chad-LaGrange-Urology-300x199Chad LaGrange, MD

We’ve taken several steps to reach this high level of patient care. It’s critical for patients living in this region to have the best urological care close to home—so they don’t have to travel long distances.

Their lives are disrupted enough when they deal with urologic conditions, including cancer. We take pride in offering the best in minimally invasive urologic surgery—both standard laparoscopic and robot-assisted laparoscopic prostatectomy.

In the past year, we’ve expanded our service significantly. Several urologists have joined our team, which allows us to treat a wider array of urological problems. Our surgeons are now performing procedures we could not offer in the past—like robotic cystectomy for bladder cancer, urethral reconstructive surgery and penile prosthetics.

You may have noticed that I mentioned “robotics” a few times here. Our patients have various misconceptions about robotic surgery.

What exactly is robotic surgery?

I’m sure our patients know there’s no robot in the surgical suite. But they may not realize that the “robotic” part involves the tools the surgeon uses.

Robotic tools are built to function like a surgeon’s hands. They allow us to perform very delicate surgery with far more precision. The surgeon’s skill and experience is still very important, and that’s a critical factor in this type of surgery. It’s our hands doing the surgery, aided by these very precise instruments.

I can explain it more when I see you, but you should know that robotic surgery helps ensure a very positive result—with far less blood loss, pain and recuperation time.

Lots of robotics experience

Of course, we perform the typical robotic prostatectomy to remove cancer from the prostate. But not many centers offer the more complex procedures—like radical cystectomy, which involves removing all or part of the bladder.

The average urologist performs only one cystectomy (maybe none) in a year’s time. At Nebraska Medicine, we do five of these complex procedures every month–a very high-volume center for bladder cancer and cystectomy. Only the top urology centers in the country are doing that. We’re proud to provide that level of expertise.

“Patient-friendly” is still a priority

With all this technology, we still pride ourselves on being friendly.

When a patient first calls our department, a “real person” will answer the phone. We don’t want people to navigate their way through lengthy phone menus. Our patients have enough stress in their lives after getting their diagnosis. We want to help relieve that stress.

We also make every effort to get a patient in to see us right away. Our patients shouldn’t have to wait long for appointments and surgery.

Our department has the exceptional nursing. Our nurses are great, very dedicated. Patients quickly form strong relationships with our nursing staff, and rely on them for support during difficult times. Our nurses take a very personal approach to patient care; they always put the patient first.

Our multidisciplinary oncology clinic is another step in that direction. Our patients can have all their appointments in one visit—radiation oncologist, medical oncologist, urologist. This makes it much easier for patients; they don’t have to travel around to get their questions answered.

With this approach, we coordinate the patient’s care more easily. We get all their physicians in the same room, which greatly improves the communication. We doctors learn a lot from each other—and as a result, our patients get better care.

We’ve also opened up new clinical trials to provide vaccine therapy for metastatic kidney cancer. The drug is in a Phase 3 trial, and results thus far are very optimistic.

These are all advantages when you are treated in an academic environment like Nebraska Medicine. And it’s all right here, close to home.

My Transplant Team is Part of My Family

Harry Danner recounts his long journey to wellness and the team who helped him get there.

I retired from the US Air Force in 1982 where I was an Electronics Warfare Specialist. Upon retirement, at age 37, I started my own electrical business. In August of 1983 I suffered a massive heart attack that left me with a heart that was barely functioning with a 10% ejection fraction.

Harry-Danner-and-FamilyHarry with his mother and sister in 1986

Needless to say, this caused many financial hardships to the tune of hundreds of thousands of dollars. Much of this was covered by my veterans’ benefits but I was still left with a huge debt. Nothing but uncertainty was ahead for me and my wife, Judy. She was my rock through everything!

Doctors were able to keep me alive with my damaged heart for two and a half years. But in 1986 they were unable to do anything else as my heart had become too weakened to keep me going much longer. In April of that year, I learned about an experimental heart transplant program at the Veterans Affairs Medical Center in Richmond, Va. Our oldest daughter flew to Plattsmouth, Neb., where we lived at the time, to help take care of the home and our youngest daughter. I was placed on the transplant list and waited for three weeks before an organ became available.

This experience sent me and my wife on the biggest adventure of our lives together. On May 11, 1986 (Mother’s Day) a heart became available. During this waiting period my wife and I went through every imaginable scenario of consequences.

The transplant turned out to be a great success. Of course, due to the inexperience of medical personnel in the field of heart transplants, I went through many episodes of major and minor rejection. The normal hospital stay after the transplant was about 90 days at that time. After I had been there for 89 days I was released and we returned to Plattsmouth, Neb. Until 1998 I returned to Richmond, Va. on a regular basis for follow up care. This was the year that the transplanted heart began to fail. For the next five years I went through just about every procedure that can be done to a heart to keep it functioning. I had developed, in laymen’s terms, what is called small vessel disease. I ended up with approximately 10 stents in my heart along with having a bypass performed on my heart.

It was by pure luck that I met Dr. Ioana Dumitru in December, 2003, at the Veterans Affairs Medical Center in Omaha, Neb. Through a very frank discussion, she explained to me that my only viable option was another heart transplant. After all the pain and procedures that I had endured over the last five years, I had pretty much come to the same conclusion. I had a bi-ventricular defibrillator implanted and Dr. Dumitru, along with her transplant coordinators, made arrangements with the University of Utah Medical Center to be evaluated for another transplant. I was accepted into the heart transplant program and it was the beginning of another trek for Judy and me.

This time things took a little more time. Although the wait time was only two and a half months, it seemed like forever to us. We kept ourselves busy by volunteering at the transplant house where we were living. Since both of us are very skilled people we were able to accomplish quite a lot in our short stay.

Harry-Judy-DannerJudy and Harry Danner

On September 3, 2004 (Labor Day) we got the call that a heart had become available. This time, we were just too nervous to drive ourselves to the hospital. The owner of the transplant house offered to drive us. We gladly accepted.

Between the time we got the notification and the time we were told to come in, Judy and I notified our family back in Nebraska and Iowa. Through some sort of miracle all three of our daughters were able to get on a plane and make it to Salt Lake City, Utah before the surgery. I was able to spend about 15 minutes with my girls before having to be taken to the operating room.

Exactly six hours later the transplant surgeon notified my family that the transplant was completely successful. After this, I was transported to the Intensive Care Unit (ICU.) Although I still had all the tubes in my neck and arms, I was still able to be brought to a completely upright position the first day after the surgery. With the bed in an upright position I was able to walk in place. I felt amazing!

By the fourth day after my transplant, I was walking up and down two flights of stairs and being transferred to a regular post transplant room. I would spend the next three days in that room. I was discharged after only seven days in the hospital back to our temporary residence.

I was supposed to spend the next six months in Utah for follow-up. But since I had a transplant team eagerly awaiting my transfer back to Omaha, I was cleared to go home after just three months. Judy and I returned home in December of 2004 and began a long and successful relationship with Dr. Dumitru, Margie Chartrand and the rest of the transplant team at The Nebraska Medical Center.

After my massive heart attack in 1983, I’ve seen many dramatic changes in the heart transplant field. Through all the changes, I believe I have the best transplant care team in the business at The Nebraska Medical Center. They are more than just a team, they are a part of my family.

New Endovascular Device Improves Outcomes for Severe PAD Patients

Cardio-PictureA new minimally-invasive procedure to treat peripheral artery disease (PAD) now available at Nebraska Medicine is allowing doctors to treat severely-hardened or completely-blocked arteries with improved outcomes.

The only one of its kind in the area, the Avinger Ocelot system combines the use of a minimally-invasive catheter combined with visual guidance to wisk through blockages that typically might require bypass surgery.

“This has expanded the number of patients we can treat without the need to perform bypass surgery or amputation,” says David Vogel, MD, vascular surgeon at Nebraska Medicine, who has received specialized training to perform the procedure. “Many patients are not candidates for bypass surgery because they have too many other medical comorbidities. Amputation then becomes their only option.”

Getting treatment is critical as untreated PAD result in limb loss.

The Ocelot catheter acts like a corkscrew to cut through a blockage. A guide wire is then passed through the area followed by the insertion of a balloon, stent, or removal of the plaque through arthrectomy, restoring blood flow to the legs. The catheter also includes lighting which allows physicians to see real-time images from inside the artery using optical coherence tomography.

“Before this procedure, we could only get across and treat around 70 percent of complete blockages,” says Dr. Vogel. “Now with the Ocelot catheter we are able to get across over 90 percent of these complete blockages and treat them. Getting through heavily calcified plaque still remains one of our biggest challenges.”

Many patients can go home the same day and return to normal activities within a couple of days, notes Dr. Vogel.

PAD affects about 1 in 20 Americans over the age of 60 and the risk continues to rise as you get older, according to the National Institutes of Health. Primary risk factors include smoking, older age and having certain diseases or conditions. It is also most common among African-Americans. Smoking increases a person’s risk for PAD by fourfold. Smokers also typically develop symptoms 10 years earlier than the general population. Conditions that increase your risk for PAD include diabetes, high blood pressure, high blood cholesterol, coronary heart disease, stroke and metabolic syndrome.

Common symptoms include calf or buttock pain when walking. As the condition progresses, patients may also experience pain in the feet at night. If a patient has gangrene or non-healing lesions, treatment is more urgent as the longer a patient waits, the more difficult to achieve healing for these patients.

To determine if your patient is a candidate for this procedure, a treadmill test should be performed by someone experienced in performing these tests. “These tests are often inaccurate when performed in unexperienced hands,” says Dr. Vogel.

It is estimated that more than 200,000 amputations are performed each year as a result of PAD and other complications such as diabetes. “With this new endovascular device, we will be able to avoid amputations in many patients,” says Dr. Vogel.