Cut Out for the OR
Surgeons at Sturdy Talk Experience, Patients Share Their Stories
“I’ll never forget what Dr. Statman said when he visited after my surgery.”
Jackie Robbins, sitting in the Oncology Clinic waiting area in her peach-colored volunteer jacket and Sturdy Memorial Hospital name badge, smiles.
“I was poking fun at my own appearance—I hadn’t plucked my eyebrows or done my hair in the week I recovered at the hospital, I was in a johnnie and had an ostomy bag—and said to him, ‘Dr. Statman, you’ve truly seen me at my worst.’ He just looked at me and laughed. ‘No,’ he said. ‘I saw you at your worst a year ago. Your insides were a mess.’”
Jackie was diagnosed with stage 4 rectal cancer in 2012. She underwent chemotherapy, radiation therapy, and several surgeries at Sturdy. In February 2013, she had a rectal resection performed by Dr. Richard Statman, board certified General Surgeon with specialization in Oncological Surgery.
“What a nice doctor. He’s genuine, telling it like it is but with compassion.”
Jackie’s was an advanced, difficult case, rendering a permanent ostomy likely. “But she didn’t want that,” says Dr. Statman. He performed a sphincter-sparing rectal resection that warranted only a temporary ileostomy, which was removed five months later during another (reversal) surgery.
“Employing methods and tactics that minimize pain and hospital stay, shorten recovery times, improve safety, and enhance quality of life, are our goals here,” says Dr. Statman.
Jackie, 50, a resident of Cumberland, RI, has returned to all the things she loves. These include spending time with her children and grandchildren, attending shows and concerts, and taking trips to New Hampshire with her husband. Even volunteering every Tuesday at Sturdy’s Oncology Clinic.
“I’ve had such good experiences at Sturdy with my doctors, nurses, and treatments, that I want to give back. I love seeing patients, sharing our stories, and supporting them the way Sturdy has supported me,” says Jackie.
Though cancer-free since 2013, she’s still monitored for any hint of a recurrence by her Oncologist, Dr. Colleen Yavarow. “I’ll have the port that Dr. Statman put in,” pointing to the circular bump below her collarbone, “for the next year in case the cancer comes back and I need more chemo. And I have surgical-site checkups with him every six months or so, but he said I won’t need these exams much longer. It’s sad hearing this because he played such a big role in my treatment and recovery. Seeing him for my office visits reminds me how serious [my cancer] was but more importantly, how great it is that I’m still here.”
General and Oncological Surgery
As a General and Oncological Surgeon, Dr. Statman’s surgical coverage is vast. His practice consists of intra-abdominal procedures including appendectomies, hernia repairs, and surgeries on the gallbladder, stomach, small bowel, colon, and rectum. He performs surgeries on the breast and other soft tissues. And Dr. Statman also operates in emergency and acute situations.
“Sturdy is a pretty unique place,” says Dr. Statman, who’s been here since 1998. “We have substantial caseloads and volumes”—close to 10,000 surgeries are performed each year at the Hospital— “and our surgeons are experienced and board certified. Patients here aren’t being operated on by residents and doctors-in-training, which is the case in teaching hospitals and academic medical centers.
“But while we’re cutting-edge,” Dr. Statman continues, “we’re not overconfident. We know our limitations. We do the tried-and-true procedures that are best for our patient base as a community hospital, so they don’t have to travel far for advanced surgical procedures. And in rare, complicated cases where we know the larger, urban hospitals have the resources to handle, we refer our patients there.”
In Jackie’s case, where her cancer had spread to 90 percent of her liver, she needed a groundbreaking kind of surgery. Dr. Statman knew of an ALPPS procedure that a liver specialist at a Boston hospital performed, and referred Jackie to this facility.
“I have empathy for my patients and want the best for them, whatever—and wherever—that is,” says Dr. Statman.
“I was scared to leave Sturdy for this surgery,” says Jackie. “But Dr. Statman was so reassuring and just kept saying, ‘You can do this.’”
Sturdy surgeons keep current with innovative, sophisticated techniques to offer patients a wide range of surgical services locally. These include minimally invasive procedures, which involve small incisions and instruments including a tiny camera, to view and perform surgeries. Compared to open surgery, minimally invasive surgeries are generally safer and allow faster recoveries and less scarring and injury to the body. In particular, our General Surgeons regularly perform laparoscopies, a type of minimally invasive procedure dealing with the abdominal or pelvic cavities.
As in General Surgery, minimally invasive procedures continue to gain momentum in Orthopedic Surgery. Dr. James Snead, board certified Orthopedic Surgeon and Sports Medicine Specialist, has a unique expertise in shoulder, hip, and knee arthroscopies, which are minimally invasive procedures of the joints.
“In the last decade, the use of arthroscopy in repairing tears in the rotator cuff, labrum, anterior cruciate ligament (ACL), and other tendons and ligaments, as well as to treat traumatic injuries and degenerative diseases like arthritis, has grown,” says Dr. Snead. “People can try conservative, nonoperative treatments like taking anti-inflammatories, having injections, resting, modifying activities, going for physical therapy (PT), or just living with it. But if nothing is working and the pain starts to affect everyday activities—especially sleep—it’s time to intervene. Fortunately with arthroscopy, which is commonly a same-day procedure, full recovery can take just three to four months; a much shorter timeframe than with open surgery.”
Nonetheless, this typical recovery period isn’t exactly ideal, especially for people looking to get back into competitive sports.
Austin White, 17, is a North Attleboro High School senior on the varsity football team. He was doing drills during practice in early September 2014, when two of his teammates collided with each other, sending one of them into the outside of Austin’s knee.
“I felt a pop,” says Austin, a lineman who has played since freshman year, “and then pain.”
The team’s athletic trainer recommended that Austin visit Dr. Snead, who diagnosed the knee injury as an ACL tear and, three weeks later, performed an arthroscopic ACL reconstruction.
According to Dr. Snead, “ACL tears are common traumatic injuries and result in pain, swelling, and instability. But they can’t heal on their own without surgery.”
“Pros like Stevan Ridley, Logan Mankins, and Tom Brady have had ACL tears; it seems like they happen a lot,” says Austin. Always a football fan, he grew up watching ESPN and practicing football with his father, who passed away during Austin’s freshman year. Three years later, he’s facing another—physical—obstacle.
“I can’t play till March, which is unfortunate because it’s my senior year,” says Austin, who alternates football season with lacrosse in the spring. “But the minimally invasive surgery combined with PT at Sturdy will help get me back into the game as soon as possible.” Austin plans to attend a university but before that, a post-graduate year at a prep school so he can regain strength and his competitive edge for collegiate football.
When discussing the surgery itself, Austin admits he was at first nervous. But he soon felt comfortable with Dr. Snead and staff, trusting them to provide the highest quality care, tailored to his needs.
“Trust is so important when it comes to patients selecting the right surgeon, for any type of procedure,” says Dr. Snead. “So I treat my patients like family members. What would I want for one of my kids or for my mother, father, or grandfather? The best care available. Providing this, while helping them understand the procedure and encouraging them to ask as many questions as they need, helps patients feel as comfortable as possible. Though I may do numerous arthroscopies a year, this is probably the patient’s first time.”
Dr. Mark Robbin, board certified Gastroenterologist, routinely performs endoscopies, which are minimally invasive procedures that facilitate visualization, diagnoses, collection of tissue samples for testing (biopsy), and treatment of cancer and other issues along the gastrointestinal (GI) tract. The small cameras, called endoscopes, visualize the esophagus and stomach (upper endoscopies) or large intestine (colonoscopies) and enter via natural body openings, whereas laparoscopes and arthroscopes enter through small incisions.
“Endoscopies are intended to diagnose and treat diseases affecting the esophagus, stomach, small and large intestines, as well as the liver, pancreas, gallbladder, and bile duct,” says Dr. Robbin. “This includes abnormal growths and polyps, obstructions, ulcers, and bleeding in the GI tract.”
One man—Ralph Uva, a resident of Mansfield—is very familiar with endoscopies. A few times a year he sees Dr. Robbin, who, via upper endoscopy, dilates or stretches areas of scar tissue that continually builds up, owing to his gastrectomy performed at Sturdy in 1994. This surgery removed Ralph’s stomach: his treatment for a diagnosis of stage 3 stomach cancer and esophageal cancer.
“Years before that, Ralph had a radical prostatectomy to treat his prostate cancer, a hydrocele repair, an appendectomy, a hernia repair, gallstone and kidney stone surgeries, and surgery for a duodenal ulcer, all at Sturdy,” says his wife Anita. “He’s a Sturdy boy.”
“I wouldn’t go anywhere else,” says Ralph.
At 84, Ralph has had his fair share of medical hurdles, but the surgeries have helped him be able to enjoy life. Since he retired from Nissan Motors in 1993, he’s traveled with his wife to Arizona to visit their granddaughter, driven to Cape Cod every year for family vacations, and spends time with their four children and four grandchildren.
“Hiccups—figuratively and literally—won’t get in our way,” says Anita. “We aren’t the kind of people who sit at home and dwell on things. We just have to pack boxes of nutritional shakes wherever we go.” (Without a stomach, these and several other easily digestible foods have become staples for Ralph.)
Ralph adds that having the support of Sturdy has helped him and his wife of 54 years and counting, get through these obstacles. “The surgeons don’t just operate and wash their hands of it; they follow up and care about their patients,” says Ralph. “Between Sturdy, Dr. Robbin, the nurses, and staff, I just can’t say enough good things about them. They’re like family.”
Urogynecologists Dr. Barbara Stricker and Dr. Ralph Philosophe, who are board certified in Obstetrics-Gynecology as well as Female Pelvic Medicine and Reconstructive Surgery, specialize in advanced, minimally invasive surgeries. These include laparoscopic procedures that can correct ovarian, vaginal, uterine, and urinary problems with less pain and scarring, as well as shorter recovery periods.
“Newer urological procedures we do include advanced neuromodulation, which involves placing a small pacemaker-like device just under the skin to help patients with overactive bladder that’s refractory to other treatments,” says Dr. Stricker. “Also, in-office placement of Botox into the bladder can help patients with overactive bladder symptoms. Both treatments have transformed patients’ lives who have been severely limited by the embarrassment that urinary and fecal incontinence can bring.”
Ann Bissonnette, 60, has lived with multiple sclerosis (MS) since 1981, which played a role in her overactive bladder issues. That “gotta go” feeling—as frequent as every five minutes—was disruptive to her lifestyle. So in February 2013, when other treatments weren’t cutting it, Dr. Stricker performed the neuromodulation surgery, called InterStim.
“Before the surgery, I couldn’t go anywhere; I had to ‘go’ too often,” says Anne, a resident of North Attleboro. “Now I can vacation to New Hampshire, Maine, and Aruba, without hassle. I can play outside with my grandkids without interruption. With three grandchildren and one on the way, the independence and freedom the surgery has given me has allowed me to stay active, and connected.”
Gynecological surgeries that Drs. Stricker and Philosophe perform laparoscopically include hysterectomies and surgeries for fibroids, endometriosis, ovarian masses, and pelvic pain.
They also perform a unique procedure called tubal ligation reversal. “Tubal ligation reversals are microscopic surgeries that reattach the fallopian tubes that were formerly, surgically interrupted to prevent pregnancy,” says Dr. Philosophe. Women who regret having their “tubes tied” have the option of tubal ligation reversal, so they may become pregnant.
“Whenever possible, we opt for minimally invasive techniques to reduce hospital stay, pain, and recovery times,” says Dr. Philosophe.
Dr. Stricker adds, “We also work closely with a great team of anesthesiologists and pain specialists who are always looking for innovative ways to abbreviate pain and improve recovery.”
Anesthesiologists at Sturdy strive to use regional anesthesia instead of general anesthesia whenever feasible. “Compared to general anesthesia,” says Dr. Dipak Kumar, Anesthesiologist, “regional anesthesia is associated with less postoperative pain, lower incidence of adverse reactions to anesthesia such as nausea, and less stress response by the body. Regional may even be necessary, in cases where the patient has comorbidities, or additional disorders.”
Dr. Kumar joined the Sturdy team in 2011 and brought some significant advancements to the table, one that’s called a transversus abdominis plane (TAP) block.
“TAP blocks,” says Dr. Kumar, “anesthetize the nerves supplying the anterior abdominal wall and by doing so, impede sensation to the abdominal area only. We offer TAP blocks to General Surgeons for most abdominal surgeries, and TAP blocks have become the gold standard in Gynecological Surgery for both laparoscopic and open abdominal procedures because of their advantages.”
TAP blocks, and nerve blocks used for joint and other surgeries on the extremities, improve postoperative pain management and provide significant sparing of opioids like morphine. Nerve blocks are guided by ultrasound and can numb an area 18-24 hours after surgery or longer, depending on the quantity of medications used. This postpones and/or circumvents the need for opioids and other pain medications, as well as their affiliated side effects like constipation, drowsiness, and confusion.
“I started doing TAP blocks at Sturdy with C-sections performed under general anesthesia,” says Dr. Kumar. General anesthesia is used in cases of certain medical issues or in emergency situations when there isn’t enough time for spinal blocks or epidurals—regional anesthesia that impedes sensations from the waist down—to work. Once the surgery is finished, a TAP block can be administered as an adjunct to general anesthesia for better postoperative pain control.
“Medically evaluating and consulting with patients for their surgical and anesthesia readiness is important for outcomes,” says Dr. Kumar. “And performing minimally invasive surgeries whenever possible, as well as localized anesthesia, helps improve recoveries.”
Surgery at Sturdy
Sturdy Memorial Hospital provides convenient, local access to a broad array of advanced surgical services that some people associate only with larger, city hospitals. In addition to General, Oncological, Emergency, Orthopedic, Gastroenterological, and Urogynecological Surgery, we also provide Oral-Maxillofacial, Otolaryngological (Ear, Nose, and Throat), Thoracic, and Vascular Surgery, among other specialties.
Our experienced, well-trained surgeons use advanced technologies to provide sophisticated procedures, whether they are elective or emergent, same-day or inpatient. They follow the strictest safety protocols including operative site marking, infection safeguards, surgical tool counts combined with detection systems to prevent retained surgical items, and reviews of surgical findings to determine any potential for improvement.
And they work together to ensure patients are as comfortable and informed as possible throughout the surgical process.
For more information about surgeries at Sturdy, click here.