Frequently Asked Questions
Why would I choose a minimally invasive procedure instead of a traditional surgery?
In many cases, minimally invasive procedures offer some significant advantages. Those advantages include less trauma during surgery and fewer complications after. With minimally invasive procedures, you typically enjoy a shorter hospital stay (or none at all), a faster recovery and less scarring. In fact, with many of these procedures, surgeons use Band-Aids® for dressings!
Why should I choose Thomas Jefferson University Hospital for my minimally invasive procedure?
Jefferson surgeons have been performing – and pioneering – minimally invasive procedures for over a decade. Today, we have many of our surgeons have extensive experience in minimally invasive diagnostic and treatment procedures covering a wide range of medical specialties. We have experts in advanced endoscopy in our Division of Gastroenterology and Hepatology. We have leading urologists who routinely use da Vinci® Surgery for prostatectomy. And our Jefferson Hospital for Neuroscience team includes surgeons who use minimally invasive techniques to treat hard-to-reach tumors of the brain and spine using stereotactic radiosurgery, cranial base surgery and endoscopic neurosurgery.
What is the difference between laparoscopic surgery and keyhole or Band-Aid® surgery?
The terms "laparoscopic surgery," "keyhole surgery" and "Band-Aid® surgery" are interchangeable. All refer to a family of minimally invasive procedures that use small incisions and some kind of laparoscope, or high-tech camera, to guide surgeons in performing the procedures through the tiny openings. These techniques can be used for a number of procedures, including common operations like removal of the gall bladder, removal of part of the colon and removal of the kidney.
How have Jefferson operating rooms been updated for minimally invasive procedures?
Jefferson has a range of surgical suites that have been outfitted with the tools and technologies needed for minimally invasive procedures. Jefferson Hospital for Neuroscience, for example, has state-of-the-art equipment for stereotactic radiosurgery. Similarly, the Jefferson Minimally Invasive Cranial Base Surgery and Endoscopic Neurosurgery Center uses the latest digital operating rooms – the first of their kind in the Delaware Valley.
What are the advantages of stereotactic radiosurgery or radiotherapy?
Whether used alone or as a complement to traditional surgery, stereotactic radiosurgery and radiotherapy offer numerous benefits.
For starters, these treatments can be performed safely and effectively on patients who wouldn't be able to withstand traditional forms of brain or spinal surgery. Stereotactic radiosurgery and radiotherapy can also treat tumors in dangerous locations, such as the optic nerve, brain stem or spinal cord. Because they're performed on an outpatient basis, these procedures offer shorter treatment time and a dramatically lower recovery period. Finally, stereotactic radiosurgery and radiotherapy eliminate the surgical risks of infection, hemorrhage and spinal fluid leakage.
Are stereotactic radiosurgery and radiotherapy painful?
All methods of stereotactic radiosurgery and radiotherapy are virtually painless and are performed on an outpatient basis.
Single, high-dose radiation via the Gamma Knife requires that patient wear a special stereotactic head frame. This lightweight frame is attached to the skull using four small screws. To relieve any pain associated with securing the head frame, the area is numbed beforehand and a sedative is administered.
Patients who receive multiple doses of radiation often find that the biggest challenge is overcoming their initial anxiety. Because they're so tense during initial treatments, they sometimes report sore necks and backs. However, once they become familiar with the daily routine of their treatment - and realize that it's truly painless - they're able to relax.
Is stereotactic radiosurgery or radiotherapy suitable for all brain and spinal tumors?
Stereotactic radiosurgery and radiotherapy are not optimal treatments for all patients. With that in mind, patients should seek an institution that offers all the alternative treatments currently available for their particular disease. And, ideally, those treatments should all be practiced by the same medical team. This eliminates treatment bias based on a narrower, "single-tool" perspective.
In addition to assessing the versatility and objectivity of a program, patients should also consider the volume of cases handled by the medical team. When physicians have a greater depth and breadth of experience, they can confidently recommend, in some cases, no treatment when they feel observation is the most appropriate management course.
What are the side effects of stereotactic radiosurgery and radiotherapy?
For the vast majority of patients, there are virtually no side effects to stereotactic radiosurgery and radiotherapy. However, as with any medical treatment, there are some possible side effects, including hearing loss and, to a lesser extent, cranial neuropathy and radiation necrosis. Jefferson Hospital for Neuroscience's rates for these side effects are among the best in the industry.
Does hair fall out as a result of this treatment?
For the vast majority of patients, their hair does not fall out. However, some patients may experience patchy hair loss.
What are the restrictions while undergoing stereotactic radiosurgery or radiotherapy?
You will find that there are very few limitations on your day-to-day life while undergoing any of Jefferson's stereotactic radiosurgery or radiotherapy treatments. You can carry on your normal activities, including working and spending time with your family. You can even be around your children and grandchildren while undergoing treatment.
For multiple treatments, how long does each session last?
Although the actual treatment time may be as little as 20 to 30 minutes, you should allow 60 minutes each day for your appointment.
Our perioperative nursing team is committed to providing the best care and service to you during your entire surgical experience. The following are a list of questions or concerns, expressed by patients regarding their surgery and recovery. If a more specific response is needed, please don't hesitate to ask.
How can I prepare for surgery?
To prevent electrical burns from cautery use, all jewelry, including wedding rings and body piercings, hairpieces and hairpins need to be removed. No personal cell phones are permitted in the operating room.
To prevent injury, remove all dentures, hearing aids, eyeglasses, contact lenses and clothing including underwear. A patient gown will be provided to maintain your privacy.
Will my visitors be able to accompany me to the operating room?
The perioperative area, which includes the Short Procedure/Same Day Admissions Unit, Holding Area, the Operating Rooms and the Post Anesthesia Care Unit (PACU) are restricted patient areas. If the patient is 18 years or younger, both parents or guardians may accompany the child to the Holding Area and will be called to the PACU once the procedure is finished.
Patients with special needs or language interpretation requirements may have one visitor accompany them to the Holding Area. No visitors are allowed in the Operating Room.
What happens in the Holding Area?
You will be asked several questions by a registered nurse and have the required documentation reviewed and completed, if needed, by member of the surgical and anesthesia teams. Anesthesia will insert an IV catheter here. If applicable, the doctor will mark on your body the area that is to be operated on. Please take this time to ask any question you may have about your surgery.
What about the surgery schedule?
Please note that we try to have every patient go to surgery at his or her scheduled time. Sometimes due to unforeseen circumstances your surgery may be delayed. We will make every effort to keep you and your family informed of any changes in the time of your surgery.
What can I expect after surgery?
After surgery, you will be transported to one of our Recovery Rooms (PACU). Your family will receive a phone call between one to two hours after arrival in PACU to update them on your status. Your time in the PACU will vary depending upon your medical health, type of anesthesia and surgical procedures, pain management and type of unit or room you required after your procedure. If you are being discharged on the day of your procedure, your family will be notified when you have returned to the SPU, and will be able to join you there. Recovery may take from one to several hours.
Will I see/speak to the doctor after surgery?
Please leave the name of a contact person and cell number (if available) so the surgeon and/or a member of the surgical team can contact your next of kin or significant other after surgery or meet with them in the Surgical Waiting Room.
Is visitation possible after my surgery while in the PACU?
For patients experiencing an extended stay in the PACU (that is, greater than 4 hours), one to two visitors may be allowed to visit with you for 10 to 15 minutes depending on the circumstances in the PACU.
Please remember that the PACU is a critical care environment in which safety and confidentiality for all patients needs to be respected and maintained.
Your visitors may be asked to leave the PACU at anytime at the direction of the PACU Charge Nurse or the bedside nurse. If the patient is eighteen years or younger, parents/guardian will be called to the PACU once the child has arrived and is settled. Patients with special needs or those with language interpretation requirements will have their visitor or caregiver called to the PACU once the patient has arrived and is settled.
Why is it necessary for someone to be with me upon discharge?
It is a hospital policy for your safety that you are discharged from the hospital with a responsible adult. You will have received medications that cause sedation and may impair your judgment and coordination. We ask that you do not drive, operate machinery or make important business decisions for 24 hours or longer if you have had sedation.
Where do I obtain my discount parking validation?
For your convenience, there are three separate locations with machines to validate your parking ticket for a discount:
- Second Floor Gibbon, 10th Street Bridge Security Desk
- 11th Street Valet Parking office
- Emergency Room Valet Parking Office
What is minimally invasive thoracic surgery, and why is it sometimes preferable to traditional "open" procedures?
Minimally invasive thoracic surgery is surgery through small incisions (and sometimes without incisions) and without the use of rib spreading. In addition to being less painful for patients, this approach also allows for early recovery and is as effective as traditional procedures.
Does insurance usually cover minimally invasive thoracic procedures?
Yes, most insurance plans cover minimally invasive and robotic thoracic surgery.
Are there are any disadvantages to minimally invasive thoracic surgery?
No. Minimally invasive surgery will be performed by your surgeon only if it is as effective and safe as the traditional open procedure.
What surgical procedures do you offer to diagnose or treat lung cancer?
Jefferson's Thoracic Surgery Program performs several procedures designed to diagnose and treat lung cancer:
- Diagnosis – flexible bronchoscopy, mediastinoscopy, endobronchial ultrasound, fine needle biopsy
- Treatment – minimally invasive lobectomy or lung resection (such as VATS lobectomy), open traditional lung resection
What surgical procedures do you offer to diagnose or treat pleural diseases?
Procedures to diagnose and treat pleural disease involve inserting a small camera in the pleural space and removing fluid and/or biopsying the pleural surface.
What surgical procedures do you offer to diagnose and treat esophageal cancer?
Jefferson's Thoracic Surgery Program offers many procedures designed to diagnose and treat esophageal cancer:
- Diagnosis: flexible esophagoscopy, endoscopic ultrasound
- Treatment and palliation: insertion of esophageal stents, photodynamic therapy of esophageal cancer, minimally invasive esophagectomy (removal of esophageal cancer with small incisions), open esophagectomy, transhiatal esophagectomy
What surgical procedures do you offer to diagnose and treat reflux?
Gastroesophageal reflux disease – also known as GERD – is a very common condition. Many patients complain of heartburn and regurgitation of food. It is diagnosed with this set of common symptoms. We may add a few tests to the diagnosis of reflux, such as monitoring of esophageal pH (which measures how much acid the esophagus is exposed to). Most patients with reflux will be treated with medication. Occasionally, when the medication stops working, a surgical treatment may be needed. At Jefferson, we offer surgical treatment of reflux without incisions. This is called endoluminal fundoplication, and is done by endoscopy without any cuts on the skin. This is a leading-edge procedure that may help many patients overcome reflux without traditional surgery. If you do not qualify for this, you may qualify for a minimally invasive repair of your reflux.
What surgical procedures do you offer to diagnose and treat achalasia?
Achalasia is diagnosed with esophageal manometry – a type of endoscopy that measures the pressure at the valve between the esophagus and the stomach. In patients dealing with achalasia, this valve is tight. Jefferson's Thoracic Surgery Program offers a minimally invasive procedure to relieve the tightness of the valve. Most patients undergoing this procedure return home in 24 hours.
What surgical procedures do you offer to treat diseases and disorders of the thymus?
Jefferson's Thoracic Surgery Program is at the forefront of robotic surgery for the treatment of thymic disorders, such as thymoma. The robot allows us to replace an invasive median sternotomy (cutting of the breast bone) in most patients. With three half-inch incisions, we can take care of most thymic conditions, including thymoma.
What surgical procedures do you offer to treat myasthenia gravis?
A significant number of patients with myasthenia gravis benefit from the removal of the thymic gland. The traditional way of doing this surgery is through a median sternotomy (cutting of the breast bone). Through Jefferson's Thoracic Surgery Program, we perform the same surgery using three half-inch incisions and the robot – allowing for significantly less pain and faster recovery.
When is surgery a good option for someone who has excessive sweating?
Patients experiencing sweaty hands (palmar hyperhidrosis), sweaty armpits (axillary hyperhidrosis), sweaty face (facial hyperhidrosis) and facial blushing (facial rubor) may greatly benefit from surgical intervention.
What procedure(s) do you perform to address hyperhidrosis?
We perform endoscopic thoracic sympathectomy. These procedures typically take about 25 minutes.
Is hyperhidrosis performed on an inpatient or outpatient basis?
We perform this as an outpatient procedure. Most patients leave the Hospital less than 6 hours after surgery.