Endoscopic Surgery Improvement [Predicted list] in New York City in 2025!

Introduction

Endoscopic surgery has revolutionized the medical field, offering minimally invasive alternatives to traditional surgical procedures. In New York City, the epicenter of medical innovation, there have been remarkable improvements in endoscopic surgery across various specialties. This article delves into the latest advancements, benefits, and applications of endoscopic surgery in New York City, highlighting the contributions of leading medical professionals and institutions.

Advancements in Endoscopic Surgery Technology

The Dilu Men in Gastrointestinal Surgery

Dr. Jeff Milsom, the chief of colon and rectal surgery at New York - Presbyterian/Weill Cornell Medical Center, has made a significant breakthrough in gastrointestinal endoscopic surgery. He created an “anchor” called the dilu men, a sleeve that slides onto a traditional endoscope. This innovative instrument has a balloon on each end of the scope that inflates, creating a closed zone that straightens out and steadies the intestine. As a result, doctors can get a clear and steady picture of the diseased area, improving their ability to see and treat lesions more confidently.

The dilu men was born out of a collaboration among surgeons, imaging specialists, engineers, and clinicians in the minimally invasive new technologies (MINT) program at New York - Presbyterian and Weill Cornell Medicine. It has the potential to change how digestive diseases are treated. Lesions in the intestine are often difficult to access and visualize with traditional endoscopes, but the dilu men straightens the area between the two balloons, increasing the odds of treating problems like benign polyps, strictures, diverticulitis, and inflammatory bowel diseases with a scope instead of surgeries.

Unlike conventional intestinal surgeries that usually require cutting out a piece of the intestine, this minimally invasive approach eliminates the need for incisions or general anesthetic. It increases patient safety and decreases hospital stays. Research shows that open gastrointestinal surgeries have average hospital stays of eight days, laparoscopic procedures have average hospital stays of five days, while Dr. Milsom estimates that the average hospital stays for procedures performed with the dilu men will be just one to two days. Moreover, costs will be dramatically lower due to less need for anesthesia and shorter hospital stays. The U.S. Food and Drug Administration approved the dilu men in December 2016, and Dr. Milsom is already working on complementary products like the dilu men C 2, which has two extra instrument channels for more complex procedures.

Robotics and AI in Gastrointestinal Endoscopy

NYU Langone Health gastroenterologists and surgeons are at the forefront of using robotics and artificial intelligence (AI) to detect and treat gastrointestinal cancers. Dr. Seth A. Gross and Dr. Mitchell A. Bernstein were among the first doctors in the country to use the new endoscopic flex robotic system (Medrobotics) in the gastrointestinal tract. This flexible robotic scope offers an alternative to traditional surgery. The procedure involves inserting a flexible scope into the anus while the patient is under general anesthesia. Using a robotic console, physicians can snake the illuminated endoscope to the site of the lesion, where a high - definition, three - dimensional camera provides a clear view of the patient’s anatomy.

The articulating arms of the robot allow for effective work in a very tight space, enabling surgical techniques from an endoscopic point of view. This is particularly effective for removing large precancerous lesions in the lower colon, which are challenging to remove using conventional colonoscopy and may traditionally require abdominal surgery. The flexible scope also overcomes the limitations of laparoscopic instruments in the narrow confines of the pelvis, as seen in transanal total mesorectal excisions (TMEs) for treating rectal cancer.

Physicians are also evaluating emerging AI tools to enhance the detection of potentially cancerous lesions. Dr. Gross is involved in a study exploring whether real - time AI can help find polyps in patients undergoing colonoscopy. Before starting an AI - assisted colonoscopy, the doctor plugs the monitor into an AI - enabled computer. As the colon is scanned, the computer flags regions with potential abnormalities. AI provides an extra pair of eyes, improving the surface inspection of the colon compared to conventional methods. Its long - term potential extends beyond colonoscopy, potentially helping to better target areas for biopsy in high - risk patients.

Endoscopic Surgery in Plastic Surgery

Endoscopic Facelift

Dr. Thomas Romo III, a top facelift surgeon in NYC, has developed a unique facelift technique called the endoscopic composite facelift. Traditional facelift methods often involve simply pulling the facial skin back and tightening it, which can result in a distorted and windswept look, and the results may only last about a year. In contrast, Dr. Romo’s endoscopic approach has numerous advantages. It provides more natural - looking and long - lasting results, uses smaller incisions, and allows for a more rapid recovery after surgery.

A facelift can address various concerns such as tightening and rejuvenating sagging facial skin, fixing the separation between the lower eyelids and cheeks, getting rid of deep creases (nasolabial folds or laugh lines), addressing facial fat that has fallen or disappeared, eliminating jowls, and dealing with loose skin and excess fatty deposits under the chin and jaw. The endoscopic facelift procedure can take 2 - 3 hours, depending on the complexity, and when combined with other procedures like a neck lift, the surgery time will vary. Patients are given an anesthetic during the procedure and may experience some swelling, bruising, and tenderness afterward. The recovery and potential downtime range from 10 - 14 days. Incisions are small and strategically placed to conceal minimal scarring.

Facelift surgery can also be combined with other procedures like blepharoplasty (eyelid rejuvenation), brow lift surgery, and neck lift surgery to achieve the best and most natural - looking results. Dr. Romo worked with Karl Storz instruments to develop his own line of endoscopic instruments, which are now globally distributed and used by plastic surgeons around the world. He is highly respected in the field, with over two decades of experience in performing facelifts and has written numerous books and frequently lectures internationally.

Other Applications in Plastic Surgery

Endoscopic techniques are also used in other plastic surgery procedures. In abdominoplasty (tummy tuck), endoscopy can be used for selected patients who have lost abdominal muscle tone. Guided by the endoscope, the vertical abdominal muscles can be tightened through several short incisions, although it is generally not used for patients with a significant amount of loose abdominal skin. For breast augmentation, an endoscope inserted through a small incision in the underarm or the navel can assist in positioning breast implants within the chest wall, and also help in correcting capsular contracture and evaluating existing implants.

In a forehead lift, instead of the usual ear - to - ear incision, three or more “puncture - type” incisions are made just at the hairline. The endoscope helps guide the surgeon to remove the muscles that produce frown lines and reposition the eyebrows at a higher level. In reconstructive surgery, endoscopy can assist in flap surgery by allowing the removal of healthy tissue from the donor site with only two or three small incisions. It can also help in the placement of tissue expanders, ensuring their precise positioning beneath the surface to bring the greatest benefit to the patient. Additionally, it can be used in sinus surgery to pinpoint and correct sinus - drainage problems, and in carpal tunnel release to locate the median nerve in the wrist area.

Endoscopic Sinus Surgery

Procedure and Benefits

Functional endoscopic sinus surgery (FESS) is an outpatient sleep apnea procedure in New York City used to treat various sinus - related conditions. It involves inserting a small fiber optic telescope (endoscope) into the sinus openings and removing small amounts of bone and/or tissue that is blocking the nasal passages. The procedure restores the natural drainage pathways in the nose and relieves the pain and pressure associated with chronic sinusitis (inflammation of the sinus lining). It is generally done in an outpatient surgery center under general anesthesia.

The benefits of FESS are significant. It is performed through the nostrils without any skin incisions, is highly effective with minimal discomfort, provides continued relief from nasal airway obstruction, has a faster and easier recovery with less scarring than traditional sinus surgery, improves sinus function, and decreases snoring and sleep apnea symptoms. Dr. Edward Shin at the New York Sinus & Thyroid Surgery Center uses state - of - the - art endoscopic sinus surgery techniques to treat many different sinus - related conditions. The procedure can remove nasal blockages caused by nasal polyps, tumors, or other growths, improve sinus drainage by clearing obstructions and relieving inflammation, correct nasal deformities like a deviated septum or enlarged turbinates, and improve the flow of air through the nose to help patients breathe better.

Techniques and Recovery

There are several different endoscopic sinus surgery techniques. Frontal sinusotomy treats the frontal sinuses in the forehead, removes obstructions, and allows for proper sinus drainage, treating sinusitis and reoccurring sinus infections. Maxillary antrostomy treats the maxillary sinuses on the sides of the nose, clears their opening, and helps with proper drainage. Ethmoidectomy treats the ethmoid sinuses behind the eyes, corrects blockages, and creates space for drainage. Sphenoidectomy treats the sphenoid sinuses at the back of the nasal cavity, surgically opens them, and opens drainage ports. Nasal polypectomy removes nasal polyps in the nasal cavity, clears sinus obstructions, and often involves opening the sinuses.

During the surgery, the surgeon administers general anesthesia and makes all incisions inside the nose. A thin, flexible tube (endoscope) equipped with advanced fiber optic technology is inserted through the nostrils to access the sinuses. Surgical instruments are then used to remove blockages and improve sinus drainage. Most patients are discharged the same day as the surgery. They can expect mild nasal congestion for 1 - 3 weeks, and there should not be much external bruising or swelling. A nasal drip pad may be required for the first few days to catch any light bleeding. Mild discomfort can be managed with prescribed pain medication, and some temporary numbness around the teeth may occur but should subside within a few weeks. Patients are advised to avoid nose blowing as much as possible during the initial recovery stage and follow the surgeon's instructions regarding activities and follow - up appointments.

Endoscopic Airway Surgery

Endoscopic airway surgery is used to treat airway stenosis, which is an abnormal narrowing of the airway that can cause difficulty breathing. This narrowing can be caused by prior neck surgery, prolonged intubation during a major illness, neck trauma from an accident, or an unknown cause. Surgeons can often open the narrowing by working through the mouth, throat, and voice box to incise or remove scar tissue. After the tissue is cut or removed, the area may be dilated (stretched open). Patients generally notice an improvement in their breathing immediately after the surgery, but in some cases, the airway cannot be opened, and a tracheotomy (breathing hole in the neck) may need to be created. Also, the surgery may need to be repeated if the scar tissue reforms.

Post - operative care is crucial. Since the surgery is done through the mouth, there are no incisions. Patients should sleep with their head and upper body elevated to 30 degrees on pillows. They should not strain, do heavy lifting, or engage in hard upper - body exercise for 2 weeks. They can eat a regular diet but should keep it light the first night after anesthesia. In general, they can speak when needed, but their voice may be hoarse or rough for 2 to 4 days. Most patients find that regular Tylenol is effective to control pain, but a narcotic pain medication may be prescribed as a backup. Antibiotics may be prescribed for 7 days depending on the amount of tissue removed. Patients should call their surgeon if they have concerns, a fever over 101.5 degrees F, excessive neck swelling, increased warmth or redness in the neck, pain in the neck or chest with breathing or swallowing that increases, or problems urinating. If they have trouble breathing, they should go directly to the emergency room.

Endoscopic Procedures in Gastroenterology

At the Gramercy Park Digestive Disease Center (GPDDC) in New York City, gastroenterologists offer a wide range of advanced endoscopic procedures. These include colonoscopy, variceal banding, upper GI endoscopy, esophageal dilation, ph monitoring, treatment for Barrett’s esophagus, liver biopsy, hemorrhoid ligation, and small bowel capsule endoscopy. The physicians at GPDDC have extensive training and experience in gastrointestinal health treatments and are dedicated to providing the highest quality endoscopic procedures and medical care for every patient.

Colonoscopy is a common endoscopic procedure used to examine the colon and rectum for polyps, cancer, and other abnormalities. Upper GI endoscopy (EGD) allows doctors to view the esophagus, stomach, and the first part of the small intestine. Esophageal dilation is used to widen a narrowed esophagus. Ph monitoring helps measure the amount of acid in the esophagus. Treatment for Barrett’s esophagus may involve endoscopic techniques to remove abnormal cells. Variceal banding is used to treat enlarged veins in the esophagus. Liver biopsy can be performed endoscopically to obtain a sample of liver tissue for diagnosis. Hemorrhoid ligation uses an endoscope to tie off hemorrhoids, and small bowel capsule endoscopy involves swallowing a capsule with a camera to examine the small intestine.

Conclusion

Endoscopic surgery in New York City has witnessed remarkable improvements in recent years across multiple medical specialties. From the innovative dilu men in gastrointestinal surgery to the use of robotics and AI in cancer detection, and the application of endoscopic techniques in plastic surgery, sinus surgery, airway surgery, and gastroenterology, these advancements have significantly enhanced patient outcomes. They offer minimally invasive alternatives with shorter hospital stays, less pain, and better cosmetic results in the case of plastic surgery. The contributions of leading doctors like Dr. Jeff Milsom, Dr. Thomas Romo III, Dr. Seth A. Gross, and many others have been instrumental in driving these improvements.

If you or someone you know is considering endoscopic surgery, it is important to consult with a qualified medical professional. Whether it’s for a sinus problem, a plastic surgery procedure, or a gastrointestinal issue, seeking expert advice can help you make an informed decision about the best treatment option. Don’t hesitate to explore the possibilities and take advantage of the cutting - edge endoscopic surgery techniques available in New York City. Share this article with others who may benefit from learning about these advancements in endoscopic surgery.