Robotic Pulmonary Segmentectomy at Excela Health (continued) In my role as medical director of thoracic surgery and director of the robotic surgical program at Excela, I have performed more than 100 pulmonary segmentectomies. Interestingly, the procedure dates back to the surgical treatment of Tuberculosis. What is new, however, is the ability for surgeons to be able to perform these procedures using minimally invasive techniques. Many of our patients stay only one day in the hospital after the procedure. We also know that for many patients segmentectomy offers long-term survival equivalent to lobectomy. The Excela Advanced Lung Center and The Center for Lung and Thoracic Disease see more than 4,500 patients per year. To make a referral for patients with pulmonary nodules, suspected lung cancer or esophageal disease, please call 724-689-0520.
Michael Szwerc, MD, FACS Medical Director, Robotic Surgery Director of Center for Lung and Thoracic Disease
Thoracic and Pulmonary Services • Robotic assisted lung resection • Robotic assisted esophageal resection • Robotic/Laparoscopic assisted Paraesophageal Hernia Repair • Robotic assisted Nissen/Toupet/Dor fundoplication • Endoscopic sympathectomy for hyperhidrosis • Thoracic outlet procedures • Bronchoscopy with EBUS biopsy • Navigational Bronchoscopy • Video Mediastinoscopy • Tracheal surgery • Esophageal, bronchial, tracheal stenting • Chest wall resection and reconstruction • Management of pleural effusions • Pulmonary nodule management • Lung cancer screening • Robotic assisted Heller myotomy for achalasia • Mesothelioma surgery • Chemotherapy ports • Diaphragmatic plication/repair of diaphragmatic hernia • Esophageal diverticulectomy • Management of pneumothorax • Management of mediastinal masses • Robotic assisted thymectomy
Managing Sleep Apnea During COVID-19 Obstructive sleep apnea (OSA) is the most common sleep-related breathing disorder, affecting up to 10-15% of men and 4-6% of women in the United States. In patients with OSA, repeated collapse of the upper airway during sleep can result in airflow interruptions, intermittent oxygen desaturation, and fragmented nonrestorative sleep. Untreated OSA has been associated with increased morbidity and mortality, with negative effects on hypertension, coronary artery disease, arrhythmias, heart attack, pulmonary hypertension, diabetes mellitus, and other cardiovascular and metabolic disease. It has been adversely associated with depression, mood disorders, cognitive function, driving safety, and overall quality of life. Evaluation and treatment often require a sleep study to confirm diagnosis and titrate positive pressure therapy. The management of sleep apnea has been a challenge during the COVID-19 pandemic, primarily due to concerns of increased risk of transmission during a sleep study and aerosol generating procedures. As the case rate of COVID-19 rises, many sleep studies have been postponed or cancelled. However, recent data suggest that OSA may be an independent risk factor for worse clinical outcomes in patients with COVID-19 infection (Sleep Medicine Reviews, Feb 2021), highlighting the importance of addressing sleep apnea in high-risk patient populations.
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Winter 2021 I Volume 2
