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Fall 2003 AAMC Leads the Way in Minimally Invasive Surgery Which would you choose—a long gash down your leg that takes months to heal, or a 2-inch incision that allows you to return to work in a week? Most patients nationwide don't have a choice. At Anne Arundel Medical Center, they do. Vascular surgeon John Martin, Director of AAMC's Vascular Institute, is widely recognized as one of this country's pioneers in performing remote endarterectomy, a minimally invasive surgical procedure designed to treat peripheral vascular disease (PVD). This exciting breakthrough is replacing traditional bypass surgery for the buildup of cholesterol and fat in leg arteries, and the results have been dramatic. His expertise has drawn patients from all over the Eastern United States to Anne Arundel Medical Center for treatment of this disease that affects 12 million Americans. In fact, AAMC is the leading medical center in the United States performing this procedure. The only surgeon performing more of these operations is its inventor, Franz Moll in the Netherlands, with whom Dr. Martin trained. Now all vascular surgeons at AAMC perform this procedure including Jon Hupp, M.D., and Mark Peeler, M.D., and the OR team at AAMC is the best in the country at this technique. "We are really pushing the envelope of minimally invasive surgeries," Dr. Martin said. "Surgeons from all over the country come here to learn how to do this and leave excited about the benefit this procedure offers their patients." Drs. Martin, Hupp and Peeler now perform almost half of the remote endarterectomies performed nationally since starting three years ago. The traditional surgery is still the standard practice across the country with about 10,000 performed each year. About 40 percent of these could be candidates for the remote surgery, Dr. Martin said. The number is expected to rise as the word continues to spread. Already surgeons are coming to AAMC from as far away as Washington State and the waiting list for surgeons to train with Dr. Martin is 30-deep. 
The Vascular OR Team (l-r) back row: Michelle Coll, R.N., Kerry Murphy, R.N., Karen Magowan, P.A., Jon Hupp, M.D., John Martin, M.D. front row: Erin Gordan, OR Tech, Sheena Douglas, RN, Sonia Huebner, OR Tech, Mark Peeler, M.D. (not pictured Gwen Stead, R.N.) PVD is a condition caused by eating fatty foods, smoking, diabetes and lack of exercise. It occurs when excessive plaque clogs the major blood vessels to the limbs, most often to the legs. As the disease progresses, patients may experience pain when they walk or at rest and are at great risk for a stroke or heart attack. "It's so important to identify this disease, as early detection not only saves legs, but saves lives," Dr. Martin said. During a remote endarterectomy, special instruments developed by Dr. Martin and Dr. Moll are used to travel through the artery in the leg from a tiny incision in the groin and remove the plaque that is causing poor circulation. This small incision allows the patient to leave that night or the next day. Traditional bypass procedures require much longer incisions that result in up to a 10-day hospital stay and at least six weeks of recovery. Stephen Hodgins, of Arnold, suffered from symptoms of PVD, including leg pain and numbness when he walked. "I could barely walk from my car to the store," he said. "That's how bad it was. I felt like I had a ball and chain on my legs." Drs. Hupp and Martin performed a remote endarterectomy on Mr. Hodgins on May 1 and now his life is completely different. "It's like night and day," he said. "Mobility is back. It's unbelievable." Had Mr. Hodgins, who owns his own construction company, undergone open bypass, his leg would still be swollen, and he'd have a one in five chance of developing complications, Dr. Hupp said. "I feel so lucky that I live in this area and this option was available to me," he said. To learn more about endarterectomies, call askAAMC at 443-481-4000 or 800-MD NURSE. | 
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