Medical Insider Blog

Holy Cross Expands Access to Cancer Clinical Trials

  • Posted Oct 04, 2016
  • hchadmin

Holy Cross Hospital has been accepted as a member institution into the ECOG-ACRIN Cancer Research Group, which allows our physicians to enroll their patients in clinical trials being conducted in the National Cancer Institute (NCI) Clinical Trials Network.

ECOG-ACRIN was  formed by the merger of the Eastern Cooperative Oncology Group (ECOG) and the American College of Radiology Imaging Network (ACRIN).

The ECOG-ACRIN Cancer Research Group has been awarded a grant by the NCI as a member of the NCI National Clinical Trials Network (NCTN). The ECOG-ACRIN Cancer Research Group is a multidisciplinary, membership-based scientific organization that designs and conducts biomarker-driven cancer research involving adults who have or are at risk of developing cancer.

The Group is dedicated to its stated purpose, which is to achieve research advances in all aspects of cancer care and thereby reduce the burden of cancer and improve the quality of life and survival in patients with cancer. ECOG-ACRIN is comprised of over 1,100 member institutions in the U.S. and around the world. Approximately 12,000 physicians, translational scientists, and associated research professionals from the member institutions are involved in Group research. 




Stimrouter for shoulder pain in stroke patients

  • Posted Jun 21, 2016
  • hchadmin

You may not know this, but individuals who suffer from stroke commonly see the muscles surrounding their shoulder become weaker and weaker and their shoulder gradually dislocates from the socket.

When this happens, it is extremely painful, and the patient -- because of the stroke -- often lacks the ability to express the pain because they've been rendered mute by the stroke itself.

Additionally it is not uncommon for the stroke itself to damage the pain-sensing system which results in a magnification of an already extremely painful syndrome!

The Stimrouter is a small, thin wire that is implanted with a needle in the shoulder next to the axillary nerve. It is then tunneled to the surface just underneath the skin where, on the outside of the arm, a tiny patch is placed to transmit electrical signals down to the nerve for two reasons: 1) to activate the deltoid muscle, which then relocates the humorous bone into the shoulder joint stopping the dislocation, and 2) to actually block the signal of pain that is transmitted to the brain from the shoulder itself.

The appropriate candidate, first and formemost, is any stroke patient who has shoulder pain. Additionally, the Stimrouter has also been approved for stimulation of any nerve in the trunk or extremities for any nerve-related pain. Click here for a patient testimonial. 

While the shoulder pain isn't necessarily associated with nerve damage in the shoulder, it is associated with the the nerve damage in the brain itself and the consequence is an extremely painful syndrome called shoulder hand syndrome. 

Regarding sciatic nerve pain, the Stimrouter is not the best tool in the bag for these issues, but there are many other types of implantable devices for sciatic pain that work extremely well.  Many of those are standard spinal cord stimulator devices, but also dorsal root ganglion stimulator devices and many others.  
When patients ask how they can relieve the shoulder pain after a stroke, we have been having great difficulty for many years treating this problem.  Usually we brace the shoulder or put the shoulder into a sling, but this very poorly treats the underlying problem. And that is why the Stimrouter is such a revolutionary concept and product.

Shoulder pain from other causes such as labral tears and rotator cuff tears and arthritis are probably still best served by an orthopedic surgeon.
However, as technology advances, if we can get better and better at blocking pain, we may be able to treat shoulder pain itself without surgery in the future.

W. Porter McRoberts, MD
Interventional Spine and Pain Medicine  


Minimally Invasive Hernia Repair

  • Posted Apr 25, 2016
  • Michael Perez, MD

One of the most common reasons individuals seek surgical medical attention is for hernia repair. Over 600,000 hernias are repaired annually in the United States alone, the majority on an outpatient basis. 

Hernias commonly occur at natural openings in the body such as the umbilicus, inguinal canal or esophageal hiatus. They can also occur at sites of previous surgical incisions. When a loop of intestine or abdominal tissue pushes into the hernia sac, severe pain and other potentially serious complications can result.

There is no adequate nonsurgical medical treatment for a hernia. Under certain circumstances the hernia may be watched and followed closely by a physician. These situations are unique to those individuals who are at high risk for operation. Minimally invasive hernia surgery has been perfected in the past 2 decades. The goals are: to reduce pain, improve outcomes and reduce the time of recovery. In laparoscopic minimally invasive hernia surgery, a telescope attached to a camera is inserted through a small incision. This technique is the same whether or not robotic assistance is employed. Other small incisions are made in the abdomen.

The hernia defect is reinforced with a mesh and secured in position with stitches or staples, depending on the preference of the surgeon. The principles of surgical repair involve the use of prosthetic mesh to repair defects in order to minimize tension on the repair. A tension free repair has a lesser chance of hernia recurrence. In addition the risk of infection is markedly decreased compared to traditional open hernia repair. In fact, for inguinal hernia repairs, we can even perform the dissection in the extraperitoneal space, avoiding any intra-abdominal adhesions.

For all types of minimally invasive hernia repairs, patients are able to return to normal activity much faster. My experience with minimally invasive inguinal hernia repairs has shown that patient can even return to full athletic activity within 1-2 wks. A patient is a candidate for laparoscopic hernia repair if they are medically able to undergo the appropriate anesthesia. Also, the defect must be in an area that allows the surgeon to place the laparoscopic or robotic trocars in positions where repair is possible. In some very large hernias, the abdominal wall is distorted to such a degree that it is impossible to safely place laparoscopic instruments. Even in these cases the techniques learned with minimally invasive surgery can be applied to decrease the trauma of open repairs.

Patients with hernias should be referred to appropriately trained surgeons to assess the feasibility of minimally invasive hernia repair. Minimally invasive surgery involves laparoscopic techniques and robotic assistance may be appropriate as well.

Click here to learn more about Dr. Michael Perez.


About Holy Cross Hospital

Holy Cross Hospital is a nonprofit, Catholic hospital in Fort Lauderdale, Florida, dedicated to innovative, high quality and compassionate care. For nearly six decades, Holy Cross has continuously expanded its services to provide leading-edge care for their patients in Florida and for those from elsewhere in the United States. Holy Cross also offers an International Services program to ensure that patients from outside the U.S. receive the care they need.

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