Ep. 338 Surgical Options for Lymphedema with Dr. Kuldeep Singh

Ep. 338 Surgical Options for Lymphedema with Dr. Kuldeep Singh

In this episode, host Dr. Aparna Baheti interviews Dr. Kuldeep Singh who breaks down the three stages of lymphedema, their respective medical and surgical treatment options, all while sharing key insights he has developed through years of experience in treating and caring for patients with lymphedema at a high level throughout the episode. --- CHECK OUT OUR SPONSORS Medtronic HawkOne Directional Atherectomy System https://www.medtronic.com/hawkone Philips SymphonySuite https://www.philips.com/symphonysuite --- SHOW NOTES Dr. Kuldeep is a Vascular Surgeon, the Director of Limb Salvage Surgery, and Program Director at Zucker School of Medicine at North Wall Hospital in Staten Island. He begins by recounting the first time he was approached by a patient suffering from Stage 3 lower extremity lymphedema, along with his initial thought process/treatment plan for the patient. He then goes on to speak on several similarities/challenges he has encountered through treating a number of patients with lymphedema, including managing/treating psychological body dysmorphia in most patients after successful surgical treatment of lymphedema. Kuldeep underscores the gravity and risks associated with moving forward with the Charles procedure (which is also known as lymphedema debulking operation), how such a surgical option should only be considered for patients with Stage 3 lymphedema, and how to encourage and promote consistent pre-operative care. Kuldeep goes onto discuss the operation itself in detail - explaining how the surgery is best done as a team (Vascular (dissecting soft tissue and placing Wound VAC for 1 week to promote formation of granulation tissue), Plastics (skin grafting/reconstruction after 1 week), and Pathology), working within the fascial plane (differentiating fascia, muscle, and fat), dealing with calcified fat effectively, difficulty of identifying fascia in setting of lymphedema, and working near the ankle (avoiding iatrogenic injury of anterior and posterior tibial arteries and achilles tendon). We wrap up the episode by discussing postoperative course: admitting the patient into Burn ICU after each step of the procedure, reapplying Wound VAC after Vascular and Plastic portions, and only discharging the patient from Burn ICU to a rehab facility after evidence of good graft uptake. --- RESOURCES Limb Salvage for “Hopeless” Lymphedema: Reviving the Charles Procedure by Singh et al. DOI: https://doi.org/10.1016/j.jvs.2019.01.021

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Ep. 30 Transradial Access: Basic to Advanced with Dr. Aaron Fischman

Ep. 30 Transradial Access: Basic to Advanced with Dr. Aaron Fischman

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/o72eK3 Our interventional radiologist guest Dr. Aaron Fischman gets into the details of his technique, equipment and tips/tricks for transradial access, as well as its advantages in a variety of IR interventions.

26 Kesä 201847min

Ep. 29 Interview with Interventional Initiative founders Isabel Newton and Susan Jackson

Ep. 29 Interview with Interventional Initiative founders Isabel Newton and Susan Jackson

An interview with Interventional Initiative founders Isabel Newton and Susan Jackson taking us through the journey behind the awe-inspiring Without A Scalpel documentaries, including some funny stories and more exciting things to come.

17 Kesä 201837min

Ep. 28 Advanced Enteral Access with Dr. Jeffrey Chick and Dr. Ravi Srinivasa

Ep. 28 Advanced Enteral Access with Dr. Jeffrey Chick and Dr. Ravi Srinivasa

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/q7wJPr Dr. Jeffrey Chick and Dr. Ravi Srinivasa discuss what inspired them to start IRAD Lab, their advanced enteral access techniques, as well as a new technique for closing EC fistulas with laser!

7 Touko 201831min

Ep. 27 Geniculate Artery Embolization for OA with Dr. Sandeep Bagla and Dr. Ari Isaacson

Ep. 27 Geniculate Artery Embolization for OA with Dr. Sandeep Bagla and Dr. Ari Isaacson

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/cGcyzt Our latest BackTable podcast on an exciting new therapy for osteoarthritis of the knee- Geniculate Artery Embolization! Our guests Dr. Ari Isaacson and Dr. Sandeep Bagla discuss their experiences and the immense potential this trans-arterial treatment has for management of people suffering from OA.

13 Huhti 201843min

Ep. 26 Radial vs. Femoral access in IO procedures with Dr. Iannuccilli and Dr. Beck

Ep. 26 Radial vs. Femoral access in IO procedures with Dr. Iannuccilli and Dr. Beck

Dr. Christopher Beck and Dr. Jason Iannuccilli discuss radial vs femoral access in IO procedures, including the pros and cons of both, and a very informative "how I do it" for radial access by Dr. Iannuccilli.

30 Maalis 201844min

Ep. 25 Declots and the Argon Cleaner Device with Dr. Sabeen Dhand and Dr. Chris Beck

Ep. 25 Declots and the Argon Cleaner Device with Dr. Sabeen Dhand and Dr. Chris Beck

In this episode, Dr. Sabeen Dhand joins Dr. Christopher Beck to discuss arteriovenous access declot procedure with the Argon Cleaner device. We review the routine declot procedure and the different methods to get access. Dr. Dhand explains why he starts out using the Argon Cleaner device and what his endpoint is. We discuss the nuances of the device in addition to tips and tricks for using the device with declots, including external massaging the fistula and an unsheathing trick.

20 Maalis 201813min

Ep. 24 Endoscopy for the Interventional Radiologist with Dr. Srinivasa and Dr. Chick

Ep. 24 Endoscopy for the Interventional Radiologist with Dr. Srinivasa and Dr. Chick

Jeffrey Chick and Ravi Srinivasa of University of Michigan VIR. In Episode 24 they explain the advantages of using simple to learn endoscopic techniques in gallbladder, biliary and genitourinary cases.

8 Maalis 201843min

Ep. 23 Adrenal Vein Sampling with Dr. Mike Devane

Ep. 23 Adrenal Vein Sampling with Dr. Mike Devane

The procedure that everyone gets excited about! In this week's BackTable podcast Mike Devane talks us through adrenal vein sampling technique, including equipment/imaging tips and tricks, as well as pitfalls to avoid. Whether looking to build an AVS service, or just preparing for that once in a blue moon case, you're certain to take away a few pearls!

20 Helmi 201822min

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