Surgery and Recovery

Hours/Location

Lodi Memorial Hospital
975 S. Fairmont Ave. map
Lodi, California 95240
Tel: 209.339.7516
Mon.-Fri., 7am-5pm

The Surgery and Recovery department provides operative services including general, orthopedic, urology, gynecology, ENT, gastrointestinal, cardiology, thoracic and endovascular surgeries. Surgery cases include elective, urgent and emergent procedures.

Surgery and Recovery provides:

  • Outpatient surgery
  • Inpatient surgery
  • Outpatient procedures
  • Inpatient procedures
  • Outpatient I.V. infusions and blood transfusions

Physicians' offices should call to schedule patient appointments, 209.339.7516.

Radiology

A radiological exam is designed to capture an image or look inside a specific area of your body for the purpose of providing data to your medical team in order that they may make an accurate diagnosis and recommend the best course of action. All imaging areas are staffed with highly competent technologists. Radiology interpretation and consultations are provided by board certified radiologists from Delta Radiology Medical Group.  Our group of radiologists possesses over 30 years of experience offering a multidisciplinary array of specialties and subspecialties. This makes our services fully capable of diagnosing your specific medical condition by providing you the expertise typically found in most major hospital imaging centers.

Lodi Health utilizes the latest state-of-the-art technology in radiological imaging called PACS - Picture Archiving Communication System - along with digital imaging. This system creates a high resolution image allowing multiple practitioners to simultaneously view your digital image, thereby facilitating multidisciplinary collaboration. In addition, the images produced can be instantly compared with any previous images completed at all of the Lodi Health imaging locations, creating a seamless approach to your diagnostic needs.

The radiology department provides its services to outpatients, inpatients, urgent care, clinics and emergency room patients. A physician's order is required for all imaging studies. A detailed description of each imaging service follows:

General Radiography (X-ray) and Fluoroscopy

This is the section of medical imaging that uses very small amounts of ionized radiation to create images of body parts. Traditional x-rays of skeletal structures are taken most often to diagnose injuries to bones and joints. Chest x-rays are taken to reveal any process that changes the airspaces in the lungs. Soft tissue diagnoses can be made by administering "contrast media" by intravenous injection for functional studies of the urinary system. For the gastrointestinal system the contrast has to be administered either by oral or rectal routes.

Interventional Radiology

The most common special procedure is the diagnostic imaging studies of an area or organ after the injection of a radio opaque contrast media. Interventional radiology is a term that describes a procedure to correct an abnormal condition. Angioplasty, peripheral vascular stents, biliary drainage and abscess drainage are some examples of interventional radiology. There are several topics available on the Society of Interventional Radiology website at http://www.sirweb.org/.

X-ray services are conveniently available at Lodi Health. The equipment is state of the art digital systems. Our technologists are properly trained and certified to provide safe and comfortable X-ray services. All X-rays are processed and provided for the doctor to review in our PACS system saving you the wait and travel time you would experience going somewhere else. To ensure accurate and timely diagnosis, our X-ray images are sent electronically immediately to a board-certified radiologist. The following X-rays are offered:

  • Abdomen
  • Ankle
  • Chest
  • Elbow
  • Fingers
  • Foot
  • Forearm
  • Hand
  • Hip
  • Knee
  • Ribs
  • Shoulder
  • Sinuses
  • Spine
  • Tibia/Fibula
  • Toes
  • Wrist

Diagnostic Radiology

X-ray imaging is a quick and easy way for a physician to view and assess common abnormalities, such as broken bones, pneumonia, gastrointestinal or genitourinary problems utilizing ionizing radiation. The use of Radiography or Fluoroscopy will be employed to best image the specific area of concern. Information obtained will assist your physician in determining your course of treatment.

How to prepare and what to expect

During your procedure, the technologist will explain the procedure to you and answer any questions you may have. Every effort will be made to make you as comfortable as possible. During your procedure, the technologist will position you for the exam and several images will be obtained depending upon the procedure performed. Very similar to taking a photograph, you will be asked to hold your breath or not move while the image exposure is made to reduce the chance of a “blurry” picture and the need for repeat imaging.

Procedure times can range from approximately 15 minutes to two hours or more.

If preparation is required for your procedure, you will be given this information at the time the procedure is scheduled.

Cardiac Rehabilitation

Location/Hours

Lodi Memorial Hospital Outpatient Services
At Vine Street and Fairmont Avenue
975 S. Fairmont Ave. map
Lodi, California 95240
Tel: 209.339.7664

Patients requiring assistance from their vehicles should use the yellow phone in the Outpatient Services parking lot area to call for staff assistance.

About our program

Heart disease cannot be cured with medicine and interventions alone. Initially after surgery, most people feel better than ever because their heart is receiving more oxygen.  But without lifestyle modifications, arteries can become reclogged, leading to further heart damage.  Heart disease returns, as arteries can become reclogged, sometimes eight to ten years down the road.

Cardiac rehabilitation is a 12-week, intensive, interdisciplinary program that includes medically supervised exercise, diet modification, stress reduction, smoking cessation, medication management, and education about how to recognize the warning signs and symptoms. Lodi Health's Cardiac Rehabilitation program provides a supportive environment that allows patients to interact with others who have experienced a similar journey.

Who can benefit

Men and women of all ages who have had angina, heart failure, a heart attack, heart bypass surgery, valve surgery, angioplasty, and even patients with a heart transplant, can benefit from cardiac rehabilitation. Participation in cardiac rehabilitation reduces patients' risk of future heart problems and increases their life expectancy.

Stages of Cardiac Rehabilitation

Phase II – Phase II is a 12-week exercise program of three sessions per week.  Exercise sessions include warm up, aerobic exercise, resistance training and cool-down stretching.  These small classes of five or less allow for each patient’s individual needs to be met. Throughout each session, patientsl receive continuous cardiac monitoring, blood pressure checks and education tailored to individual needs. Patients can start Phase II once their physician clears them, typically two to six weeks after their heart attack, intervention or surgery.

Phase III – Phase III is also called a “maintenance phase,” with three sessions per week.  In this phase, staff works on maintaining patient fitness through an exercise prescription tailored for each patient.  Monitoring is provided once every three months and blood pressure checks are done each session.  Phase III candidates are individuals with previous heart disease, patients at risk of developing heart disease, and graduates of the Phase II cardiac rehabilitation program.

Ultrasound

Ultrasound is a medical procedure based on the application of high frequency sound waves to image various body parts.  It is based on the principle of sound waves "bouncing off" of structures and then being detected to provide structural images. Most frequently associated with imaging during pregnancy, ultrasound is used to diagnose and guide therapeutic procedures.

An ultrasound, sometimes referred to as a Sonogram, is a procedure that utilizes sound-waves to provide a detailed look at the organs and soft tissue within the body. Typical procedures include abdomen, chest, OB/pelvic, breast, thyroid along with biopsy and drainage procedures. Ultrasound is safe and painless. The entire process takes approximately 45 minutes to one hour depending upon the type of sonogram that is needed. Information obtained will assist your physician in identifying problems and plan a course of treatment specific to your needs.

How to prepare and what to expect

For most sonograms, very little preparation is required. However, you may be requested to not eat or drink plenty of liquids depending upon the type of sonogram you are having. Instructions will be given to you at the time you are scheduled.

Once you are in the ultrasound room, you will be asked to lie down on a table.  Please make sure that you are comfortable, as you will be laying on the table for approximately 45 minutes to one hour. The area that is being scanned will then be uncovered and a warm gel will be applied. The gel acts as a couplant between you and the equipment and will allow the Sonographer to obtain an optimal study. During the procedure, a device called a transducer will be moved back and forth across the area of interest. You will be asked to hold very still and at times to hold your breath until the picture is complete. A series of images will be made of the area in question.

Treatment Comparison

Comparing surgery and radiation for prostate cancer

The following table compares outcomes following prostate cancer treatment -- specifically, surgery (radical prostatectomy), which is considered the gold standard treatment for localized prostate cancer -- and radiation (brachytherapy and external beam radiation). Data is provided on survival, cancer recurrence, incidence of rectal and bladder cancer, bowel function, urinary bother and long-term erectile function. In this table, radical prostatectomy includes all approaches to prostate surgery (open surgery through large incisions; conventional minimally invasive, or laparoscopic radical prostatectomy -- also called LRP -- as well as da Vinci Prostatectomy, or dVP). As you can see, surgery offers measurable advantages over radiation in terms of outcomes and survivability.

Chart 1: Outcome Comparison: Surgery vs. Radiotherapy
Outcome
Radical Prostatectomy*
Radiation**
Survival duration compared to conservative disease management1
8.6 years
4.6 years
15-year prostate cancer survival rate2
92%
87%
Survival rate for high-grade cancer patients3
45% increase in overall survival rate vs. radiotherapy
 -
Risk of cancer-specific death for
high-grade cancer patients4
49% less risk vs. radiotherapy
 -
Cancer recurrence5
Easy to detect
Difficult to detect
Risk of rectal cancer
(Within 10 year follow-up) 6
5.1 out of 1000
10.0 out of 1000
Risk of bladder cancer7
0.8% developed bladder cancer
1.3% developed bladder cancer
Bowel function impairment8
-
Significantly greater vs. surgery
Disease-specific long-term quality of life9
Stable
Unstable
Painful urination (at 18 month follow-up) 10
1% of patients
30% of patients
Long-term erectile dysfunction11
Lower risk
Higher risk

*Open surgery; comparable long-term data not yet available on da Vinci® Prostatectomy.

**External Beam Radiation Therapy (EBRT) unless otherwise noted in the citation.

 

Comparing open vs. laparoscopic vs. da Vinci Surgery for prostate cancer

The following table looks at patient outcomes following surgery for prostate cancer (radical prostatectomy), and compares "best in class" data from three types of surgery. As you can see, da Vinci Prostatectomy (dVP) shows measurable advantages as compared to both conventional open surgery (open), performed through large incisions, as well as conventional minimally invasive laparoscopic (lap) surgery.

Chart 2: da Vinci® vs. Open vs. Conventional Laparoscopy
Outcome
da Vinci©
Open
Lap
Cancer control
 
 
 
T2 margin status
4.51
5.92
7.73
Complications
Estimated blood loss (EBL)
109 ml4
1355 ml5
380 ml6
Length of stay (LOS)
1.2 days4
3 days5
2.5 days13
Major
1.7%4
6.7%5
3.7%6
Minor
3.7%4
12.6%5
14.6%6
Urinary function
3 month
92.9%7
54%8
62%9
6 month
94.9%7
80%8
77%9
12 month
97.4%7
93%8
83%9
Sexual function
12 month
86%10
71%11
76%12

 

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References for Chart 1:

[1] Tewari A, Raman JD, Chang P, Rao S, Divine G, Menon M.  Long-term survival probability in men with clinically localized prostate cancer treated either conservatively or with definitive treatment (radiotherapy or radical prostatectomy). Urology. 2006 Dec;68(6):1268-74.
[2] Tewari A, Raman JD, Chang P, Rao S, Divine G, Menon M.  Long-term survival probability in men with clinically localized prostate cancer treated either conservatively or with definitive treatment (radiotherapy or radical prostatectomy). Urology. 2006 Dec;68(6):1268-74.
[3] Tewari A, Divine G, Chang P, Shemtov MM, Milowsky M, Nanus D, Menon M.  Long-term survival in men with high grade prostate cancer: a comparison between conservative treatment, radiation therapy and radical prostatectomy--a propensity scoring approach. J Urol. 2007 Mar;177(3):911-5. Erratum in: J Urol. 2007 May;177(5):1958.
[4] Tewari A, Divine G, Chang P, Shemtov MM, Milowsky M, Nanus D, Menon M.  Long-term survival in men with high grade prostate cancer: a comparison between conservative treatment, radiation therapy and radical prostatectomy--a propensity scoring approach. J Urol. 2007 Mar;177(3):911-5. Erratum in: J Urol. 2007 May;177(5):1958.
[5] Di Blasio, C. J., A. C. Rhee, et al. (2003). Predicting clinical end points: treatment nomograms in prostate cancer. Semin Oncol 30(5): 567-86.
[6] Baxter NN, Tepper JE, Durham SB, Rothenberger DA, Virnig BA. Increased risk of rectal cancer after prostate radiation: a population-based study. Gastroenterology. 2005 Apr;128(4):819-24.
[7] Boorjian S, Cowan JE, Konety BR, DuChane J, Tewari A, Carroll PR, Kane CJ; Cancer of the Prostate Strategic Urologic Research Endeavor Investigators. Bladder cancer incidence and risk factors in men with prostate cancer: results from Cancer of the Prostate Strategic Urologic Research Endeavor. J Urol. 2007 Mar;177(3):883-7; discussion 887-8.
[8] Litwin MS, Sadetsky N, Pasta DJ, Lubeck DP. Bowel function and bother after treatment for early stage prostate cancer: a longitudinal quality of life analysis from CaPSURE. J Urol. 2004  Aug;172(2):515-9.
[9] Miller, D. C., M. G. Sanda, et al. (2005). Long-term outcomes among localized prostate cancer survivors: health-related quality-of-life changes after radical prostatectomy, external radiation, and brachytherapy. J Clin Oncol 23(12): 2772-80.
[10] Buron, C., B. Le Vu, et al. (2007). Brachytherapy versus prostatectomy in localized prostate cancer: Results of a French multicenter prospective medico-economic study. Int J Radiat Oncol Biol Phys 67(3): 812-22.
[11] Di Blasio, C. J., A. C. Rhee, et al. (2003). Predicting clinical end points: treatment nomograms in prostate cancer. Semin Oncol 30(5): 567-86.
 

References for Chart 2:

[1] Ahlering TE, Woo D, Eichel L, Lee DI, Edwards R, Skarecky DW. Robot-assisted versus open radical prostatectomy: a comparison of one surgeon's outcomes. Urology. 2004 May;63(5):819-22. p. 821 table III.
[2] Scardino PT. Open Radical Retropubic Prostatectomy. Presented at the American Urological Association’s Carcinoma of the Prostate Course, San Francisco, California, Sept. 30 – Oct. 1 2005 
[3] Touijer K, Kuroiwa K, Saranchuk JW, Hassen WA, Trabulsi EJ, Reuter VE, Guillonneau B. Quality improvement in laparoscopic radical prostatectomy for pT2 prostate cancer: impact of video documentation review on positive surgical margin. J Urol. 2005 Mar;173(3):765-8. p. 766 (Results)
[4]  Bhandari, A., McIntire, L., Kaul, S.A., Hemal, A.K., Peabody, J.O., and Menon, M. (2005). Perioperative complications of robotic radical prostatectomy after the learning curve. J Urol 174, 915-918.
[5] Brown, J.A., Garlitz, C., Gomella, L.G., McGinnis, D.E., Diamond, S.M., and Strup, S.E. (2004). Perioperative morbidity of laparoscopic radical prostatectomy compared with open radical retropubic prostatectomy. Urologic oncology 22, 102-106.
[6]  Guillonneau, B., Rozet, F., Cathelineau, X., Lay, F., Barret, E., Doublet, J.D., Baumert, H., and Vallancien, G. (2002). Perioperative complications of laparoscopic radical prostatectomy: the Montsouris 3-year experience. The Journal of urology 167, 51-56.
[7] Locke, DR, Klimberg IW and Sessions RP. Robotic Radical Prostatectomy With Continence And Potency Sparing Technique: An Analysis Of The First 250 Cases. Submitted To Journal Of Urology, Publication Date TBD. p. 5 table 4.
[8] Walsh PC. Patient-reported urinary continence and sexual function after anatomic radical prostatectomy. J Urol. 2000 Jul;164(1):242. p. 59 table 1.
[9] Goeman, L., Salomon, L., La De Taille, A., Vordos, D., Hoznek, A., Yiou, R., and Abbou, C.C. (2006). Long-term functional and oncological results after retroperitoneal laparoscopic prostatectomy according to a prospective evaluation of 550 patients. World J Urol 24, 281-288.
[10] Kaul, S., Bhandari, A., Hemal, A., Savera, A., Shrivastava, A., and Menon, M. (2005). Robotic radical prostatectomy with preservation of the prostatic fascia: a feasibility study. Urology 66, 1261-1265.
[11] Parsons JK, Marschke P, Maples P, Walsh PC. Effect of methylprednisolone on return of sexual function after nerve-sparing radical retropubic prostatectomy. Urology. 2004 Nov;64(5):987-90.
[12] Su, L.M., Link, R.E., Bhayani, S.B., Sullivan, W., and Pavlovich, C.P. (2004). Nerve-sparing laparoscopic radical prostatectomy: replicating the open surgical technique. Urology 64, 123
[13] Dahl DM, L'esperance JO, Trainer AF, Jiang Z, Gallagher K, Litwin DE, Blute RD Jr.  “Laparoscopic radical prostatectomy: initial 70 cases at a U.S. university medical center.”Urology. 2002 Nov;60(5):859-63.