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Colace (Docusate)

The list of surgeries that have switched over to the laparoscopic video method grows daily. It includes these:
• Lungs. Until now, the removal of a section of lung or the taking of a sample of tissue from the lung for microscopic examination meant a patient had to spend at least a week in the hospital plus a month or more recovering. The surgeon performed a thoracotomy, opening a window into the chest. To do that, the physician and his assistants cut a giant opening across the patient’s back and chest. With special clamps, they spread apart the adjoining ribs and, if necessary, broke them. The resultant postoperative pain often swamped the patient.
Dr. Ralph Lewis heads the thoracic surgery department at the Robert Wood Johnson University Hospital and St. Peter’s Medical Center in New Brunswick, New Jersey. Last September, Dr. Lewis performed video surgeries for a biopsy of a diseased lung and for the removal of a lobe of a cancerous lung.
“It’s like looking for a penny under a subway grating,” Dr. Lewis says of video surgery. “You stick your instruments and TV camera between the ribs, using the TV image to guide them. There is no need to break the ribs.” He points out that, with this method, a surgeon can remove an accumulation of fluid from the chest or from around the heart of a patient. “I’ve had calls from heart surgeons who are interested in this procedure,” Dr. Lewis adds.
• Prostate gland. The video laparoscope has been used in the removal of cancerous prostate glands. Again, this procedure saves the patient pain and recovery time, both while in the hospital and while convalescing at home.
Dr. R. Ernest Sosa, an urologist at New York Hospital in Manhattan, has used video surgery to battle prostate cancer. He removes the lymph nodes that drain the prostate gland. Those nodes move fluid around the body outside the bloodstream. If a cancer has spread, the lymph nodes are the first to get the deadly cells. With the nodes out, the microscope reveals whether they are cancerous.
“If the nodes are clean,” Dr. Sosa says, “and the biopsy of the prostate shows cancer, we go in and cut out the organ or treat it with radiation, and the patient has an excellent future.” He adds, however, “If the lymph nodes are cancerous, treating the prostate itself is insufficient.” In that case, Dr. Sosa says, “We do not operate or radiate – we treat the patient with medication.”
The medication stops the production of the hormone testosterone, on which four out of five prostate cancers depend for growth. Although this treatment slows the disease and improves the patient’s quality of life, it unfortunately is not a cure.
• Colon, pancreas, liver. Dr. Cooper-man and other surgeons already have used the video technique to remove sections of diseased large bowels from patients. There is one report of 20 total colon removals with no deaths. Patients are able to go home in 3 to 5 days, instead of the usual 10 days. Dr. Cooperman, well known for his skill in pancreatic surgery, also has taken liver samples using video surgery. And Dr. Reich of Philadelphia has used the video method to repair injured bowels and urinary bladders.

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