Patient-focused and Progressive
Medical Center, we want your surgical experience to be as safe, comfortable,
and stress-free as possible. From your pre-admission testing to the time of your
discharge, we will do our utmost to meet your individual needs and honor your
We perform all
inpatient surgery at the medical center. Same-day surgery and outpatient
procedures take place at two locations: at the main campus in the medical
center’s Same-day Surgery Center, Schuyler Hospital and at Surgicare, on the Convenient
Care Campus at Ithaca, located on Arrowwood Drive off
teams perform thousands of procedures a year and help our patients through
recovery. We understand, however, that for most of our patients surgery is an
unfamiliar experience. Our goal is to take excellent care of you, to educate
you and your family about your surgery and what to expect during recovery, and
above all, to help you get better.
If at any time
during your stay you have questions, please ask us. You are the reason
Center offers a broad range of inpatient and outpatient surgery. We do this so
that you can stay close to home when you require surgery. Having family and
friends nearby for love and support is important to your recovery.
Your Hospital Visit
Whether you are having
same-day surgery or are staying overnight at the medical center, you need to go
through pre-admission. We do this to ensure that you are ready for surgery before
the day of your operation.
Making your appointment
Your doctor’s office will call the
medical center for you to set up your pre-admission appointment. We schedule
pre-admission appointments Monday-Friday, between 8 a.m. and 4 p.m.
Your pre-admission appointment and testing
should be completed within seven days of your surgery.
Your doctor will perform a health history
and physical examination during an office visit prior to your pre-admission
appointment. Then, depending on the procedure you’re having, your doctor
will order one or all of the following tests to be performed during your
pre-admission appointment at the medical center: -blood tests (which
require a needle stick)
During the pre-admission
During your pre-admission
appointment, the nurse will discuss with you
instructions for the day and evening prior
to your surgery
how and when you will be discharged
planning for home-care services if you need
them following surgery
Your pre-admission nurse
will also review a pre-surgery checklist with you and make sure that you have
arranged for transportation to and from your surgery.
What you should bring to
your pre-admission appointment
a list of your current medications and the
the anesthesia questionnaire from your
your health insurance cards
a list of your prior surgeries
a copy of your living will, health care
proxy, or power of attorney for your medical record
at the Highest Standard of Care
At Cayuga Medical Center
and Surgicare, only board-certified anesthesiologists administer anesthesia. By
way of contrast, many hospitals have systems whereby a single anesthesiologist
may supervise a number of nurse anesthetists in different rooms who are
administering patient anesthesia.
ensure maximum control and patient safety, we only recruit anesthesiologists
who perform their own anesthesia. We have ten anesthesiologists on staff.
anesthesiologist will take care of you from beginning to end, which increases
safety and provides continuity for each patient.
are many choices regarding the specific anesthesia to be used. This decision is
made jointly by you and your anesthesiologist with input from your surgeon, so
that the anesthesia choice is appropriate for you and the anesthetic plan
addresses your individual concerns.
More about Anesthesia
Patients typically have lots of questions
for their anesthesiologists. Here, anesthesiologist Dr. Mattison
Burt answers some of the most frequently asked questions.
What is anesthesia?
Anesthesia is the loss of sensation using
medication and is a crucial part of the surgical experience. The anesthetized
patient is not physically aware of the surgical procedure. Anesthesia can be
administered in a number of ways. Under general anesthesia, the patient is
completely unconscious. Regional and local anesthesias
target specific areas of the body affected by the surgery; the patient is awake
but typically sedated.
How do you determine the appropriate
type of anesthesia?
The type of anesthesia depends largely on
the surgical procedure being performed. General anesthesia is typically used
for surgery of the chest, abdomen, brain, and spine, as well as for major
breast surgery and laparoscopic removal of the gallbladder or appendix.
Regional anesthesia, which allows us to anesthetize or "block"
specific nerves, is used for a wide variety of surgeries ranging from joint
repair and replacement to hernia repair and cesarean section.
Will the anesthesia make me sick?
Studies show that the primary fear people
have about receiving anesthesia is that it will make them nauseous and want to
vomit. (The fear of pain is secondary, interestingly.) However, there have been
significant advances in anti-nausea medications we use to prevent and treat
nausea following surgery and anesthesia. We are also better at identifying risk
factors that may indicate a higher incidence of nausea and vomiting. Among
these are patients undergoing abdominal laparoscopic surgery and people having
procedures that require a high amount of narcotic for pain control.
What are some of the important
advances in anesthesia?
By far the most important are those that
have increased the safety of administering anesthesia. The risk of death or
significant injury from anesthesia is extremely low with technology such as
pulse oxymetry, which continually measures the level
of oxygen in the patient's blood, and capnography,
which measures the patient's exhaled carbon dioxide. This helps confirm the
proper placement of breathing devices that secure the patient's airway.
Automation in the operating room, such as automated blood pressure,
electrocardiograms, and other technologies, provide continuous updated
information about the patient.
Another important advance is the expanded
use of regional anesthesia (nerve blocks), which minimizes the undesirable
effects of general anesthesia. Nerve blocks can last for several hours after
surgery, giving the patient significant pain relief after the procedure. The
result is that patients need less pain medication and their regimen of pain
medication is shorter. A considerable amount of surgery performed at Cayuga
Medical Center and Surgicare is done with regional anesthesia.
What is the role of sedation in
The medications used to sedate patients who
receive regional anesthesia are easily tolerated, short acting, and they clear
from the body quickly, usually with minor after-affects.
Most patients are sedated with nerve blocks. Sedation makes the patient
comfortable and relaxed while the surgeon is working. These medicines have a
calming effect and they also allow the patient to lie in what might otherwise
be an uncomfortable position without feeling discomfort. Some of these
sedatives also have amnesic properties; the patient can be awake during the
procedure but may not remember it. A small number of patients choose to observe
their surgery, typically shoulder or knee arthroscopy, and they ask not to be
sedated. This allows them to watch the procedure on the video monitor.
In summary, the new anesthesia and sedation
medications are more focused and their properties are intended to work in very
specific ways with fewer side affects. I believe regional
anesthesia is under utilized in many medical centers. We use regional
anesthesia whenever possible at Cayuga Medical Center and Surgicare, which I
think has a genuine benefit for our patients.
Gets Rave Reviews
Surgicare, our outpatient
satellite surgery center, consistently garners high patient satisfaction
ratings for its patient-friendly approach and
convenience, especially for people with restricted mobility. Located on
the Convenient Care Campus on Warren Road in Ithaca, Surgicare makes it easier
for many people in Tompkins County and the region to have routine outpatient
surgery nearer to where they live and work.
Surgeon specialists and
gastroenterologists perform a number of procedures at Surgicare:
· leading-edge eye surgery
invasive varicose vein surgery
nose, and throat surgery
and cosmetic procedures
(including colonoscopy and other diagnostic and minor surgical procedures)
· minimally invasive laparoscopic
surgery specialists take care of patients requiring:
for injuries from traumatic accidents
- Surgery for
all types of cancer (breast, colon, lung, etc.)
(chest) surgery, major and minor abdominal procedures, including
digestive tract, biliary tract (liver, gallbladder, pancreas)
surgery on the circulatory system (arteries and veins)
system procedures (thyroid and parathyroid glands that produce the body’s
- Skin and
soft tissue surgery
All of our
general surgeons subspecialize within their field,
advancing their skills in areas such as:
· Laparoscopic (minimally invasive) abdominal surgery and hernia
· Thyroid and parathyroid procedures
· Tissue-conserving breast-cancer surgery
Vascular surgery (to open up blockages in the
carotid and aortic arteries, bypass surgery for arterial obstructions in the
legs, and for repair of abdominal aortic aneurysms)
(including minimally-invasive varicose vein surgery)
· Nissen fundoplication
· Bariatric surgery (to treat morbid obesity)
· Fast-track colorectal and intestinal surgery
· Please read Health Visions Magazine Spring 2008, article entitled Surgery on the Fast Track
Ear-Nose-Throat (Otorhinolaryngology) and Head and Neck Surgery
Our ENT and Head and Neck
surgeons treat a wide range of acute and chronic problems, involving both
illness and congenital conditions, such as:
snoring and obstructive sleep apnea
endoscopic sinus surgery or FESS (to treat chronic sinus infections)
surgery (to repair damaged vocal cords)
of tonsils and adenoids
and tubes (to drain fluid from the ear)
(to improve breathing)
(to repair eardrum injuries)
(to diagnose congenital malformations of the trachea and larynx, and to remove
reconstructive and orthopedic surgeons perform hand surgery at Cayuga Medical
Center and Surgicare. Powerful surgical microscopes enable them to
repair the delicate bones, tendons, ligaments, and nerves located in the hands
injuries resulting from traumatic accident
joint arthroscopy for injuries due to trauma or repetitive motion
● Endoscopic carpal tunnel surgery to relieve nerve compression
● Reconstruction and replacement of painful arthritic joints
Head and Neck Surgery
In addition to ENT
surgery, these surgeons perform cleft lip and palate repair and delicate phonosurgical and laryngeal framework surgery for diseases
of the larynx.
a multidisciplinary approach and the newest surgical technology, we treat
patients at Cayuga Medical Center with advanced cancers of the nose, mouth,
throat, and esophagus.
ability to offer conservation surgery and functional reconstruction helps to
preserve the swallowing, vocal, and breathing functions while eradicating the
cancer and leaving patients cosmetically intact.
Head and Neck
Surgery for Cancer
Gastroenterology and Endoscopy
The gastroenterologists at
Cayuga Medical Center are at the leading edge of their field of specialty. They
diagnose and treat digestive tract problems including swallowing difficulties,
stomach ailments, liver disease, and problems affecting the intestines and
colon. In their work, gastroenterologists use a narrow, flexible tube with a
light source and a tiny video camera at its tip. This is inserted into the
body, giving a detailed look inside the digestive tract.
We offer comprehensive video-endoscopy services
at both the medical center and at Surgicare, on the Convenient Care Campus at
Ithaca, including both EGD (esophagogastroduodenoscopy) and colonoscopy.
24-hour wireless esophageal pH testing for
diagnosing gastroesophageal reflux disease (known as
GERD or heartburn)
capsule endoscopy to identify diseases of
the small intestine, which are typically difficult to diagnose using radiologic
or endoscope technologies
Maxillofacial and Oral Surgery for
the Face and Facial Bones
This field of surgery involves
the face and facial bones, nasal surgery, orthognathic
surgery (jawbone realignment), cleft lip and palate surgery, cheek bone and
chin surgery, arthroscopic temporomandibular (TMJ)
surgery, extractions and jaw implants (permanent replacement of missing teeth
and jaw reconstruction).
Cleft Palate and
Under the leadership of
Dr. Jeffrey Lewis, a surgeon specializing in facial plastics and maxillofacial
surgery, our Cleft Facial and Deformities Team provides needed support for cleft
palate patients and their families. Since our program started, we have
evaluated more than 100 children and a number of adults with cleft lip, cleft
palate, and other deformities. Our team is eager to provide services to
children of all ages, and adults as well.
team includes approximately 20 area specialists in oral and maxillofacial
surgery, pediatric medicine, plastic surgery, ear-nose-throat, maternal-child
care, audiology, speech and occupational therapy, social work, developmental
psychology, dentistry, orthodontics, genetics, early intervention program, and
parent support group.
specialists work together to provide comprehensive care and to facilitate a
smooth transition into the care network for infants and their families.
A team of neurosurgeons
with more than thirty years of collective experience performs neurosurgery at
Cayuga Medical Center. They work with a highly trained group of operating-room
and intensive-care-unit professionals to treat a wide variety of neurosurgical
problems affecting the spine, neck, and brain, including:
disks, spinal fusions, and lumbar stenosis (impinged
nerve functioning due to narrowing of the spinal canal)
and malignant tumors of the brain and spine
and other hemorrhages in the brain, brain injury from trauma or stroke
(accumulated fluid in the brain)
of the neck and spine
Obstetric and Gynecological
Surgery Includes VBAC
Although vaginal birth
after a previous c-section (VBAC) is now considered to be a safe childbirth
choice for many mothers, not many hospitals offer this option to expectant
mothers. At Cayuga Medical Center, VBAC is available as part of our commitment
to provide a variety of birthing options to our community.
surgeons also perform extensive specialty surgeries:
hysteroscopy to correct causes of uterine internal bleeding
ablation for menorrhagia (heavy menstrual bleeding)
to remove uterine fibroids
ligation to prevent pregnancy
for prolapse of the female genital organs, including
bladder prolapse and urinary incontinence
Ophthalmologic (Eye) Surgeons at
Due to the ongoing involvement
of our eye surgeons in the clinical testing and development of surgical
instruments, phacoemulsification (lens extraction)
equipment, and lens implantation devices, people in our region have access to
the very newest technology, making cataract surgery safer for our patients. Our
medical staff includes specialists in both adult and pediatric ophthalmology.
Eye surgeons on staff at
Cayuga Medical Center routinely perform:
surgery for cataract removal and lens replacement
eye exams and pediatric surgery for amblyopia and
and eye muscle surgery
of detached retina and retina surgery for those with eye damage from diabetes
surgery (to correct nearsightedness and astigmatism)
Orthopedic Surgery and
orthopedic surgeons operate at both Cayuga Medical Center and Surgicare. They
offer the latest, minimally invasive approaches for joint replacement and
revision, operating through small incisions. They routinely introduce new
surgical procedures, such as the use of custom-made models for minimally invasive
knee-replacement surgery, Copeland shoulder resurfacing for painful arthritis,
and elbow arthroscopy to treat joint derangement. Our orthopedists treat:
· Fracture surgery for accident victims
types of sports-related injuries
arthroscopic shoulder, knee, wrist, and hand surgery, including endoscopic
carpal tunnel surgery
repair and fracture reduction
joint replacements of the hip, elbow, shoulder and other joints, including both
total and unicondylar knee replacement
invasive joint revision, for repair and replacement of existing joint
Joint Solutions: State-of-the-art Joint
Replacement at CMC
Joint pain can be caused
by injury or inflammation to the joint. The most common cause of joint
inflammation is osteoarthritis. This occurs when the cartilage covering the
ends of the bones wears away, resulting in pain and stiffness.
can be treated conservatively with medication, weight loss, exercise to
increase range of motion and gain strength, and the use of an assistive device
(such as a cane) to relieve stress on the joint.
The goal in treating
inflammation is to relieve pain and improve joint function. However, when
conservative measures are unsuccessful and the pain you experience diminishes
your quality of life, your doctor may recommend total joint replacement
Let us tell you about Joint Solutions.
The name Joint Solutions reflects the goal of
our program: To assist patients in
working toward a solution to joint pain and deteriorating function.
We know from patient
satisfaction surveys that our patients are satisfied with the education we
provide throughout the program, the quality of care they receive, and the favorable
outcomes from joint replacement surgery. Knowledge is the power that motivates
joint replacement patients to strive for and gain optimal function. As a
result, they can resume their lives without the pain they lived with prior to
The Joint Solutions program has three
components to help you through joint replacement surgery.
1) Before Surgery: Getting Ready
Once you and your surgeon
have decided on joint replacement, the surgery is scheduled. At this time, you
enroll in a pre-operative education class led by the Joint Solutions program
director and an experienced orthopedic nurse.
In class you learn what to
expect and how to prepare for the surgery. The class also gives you an
opportunity to ask questions and interact with other people preparing for
surgery. You’ll learn about the importance of pre-operative exercises in
preparation for the surgery and you’ll receive a journal outlining what
to expect before, during, and after the operation.
2) Your Stay at Cayuga Medical Center
The surgical day includes
completion of the surgery and optimal post-operative pain control. Our staff
will monitor your vital signs and pain level, and will prepare you to begin
moving around the next morning. Experienced orthopedic nurses and physical
therapists will teach you about total hip precautions and total knee care,
depending on the surgery you’ve undergone. This important education and
awareness component continues throughout your hospital stay.
Group physical therapy
begins in our Joint Solutions gym and continues twice a day, every day, in
preparation for discharge. Therapy works on improving strength, range of
motion, and mobility. The family member or friend who is acting as your coach
is invited to attend these classes to observe and to assist you.
Group physical therapy
sessions continue twice a day. As the exercises become more advanced, walking
and distances increase, and you will become more independent. You’ll also
progress to stair climbing and learn more about total hip precautions and self
total knee stretches. Our occupational therapist will assist you with
activities of daily living and make recommendations regarding assistive devices
(such as reachers, sock aids, or long-handled
Group physical therapy
classes continue. Your coach should plan to attend, to help you maximize your
gains in independence and function. We wrap up the stay with a gourmet meal for
lunch or dinner so that you and your coach can celebrate your success.
Prior to discharge, our
discharge-planning nurse will assist you in obtaining necessary equipment and
setting up home-care services for physical therapy and nursing. You and your
home-care therapist will continue to work for two to four weeks on gaining
strength, improving range of motion, and walking without the use of a cane or
After home-care therapy
has ended, your surgeon may recommend continued outpatient physical therapy. Outpatient
physical therapy is available in our Department of Physical Therapy and Sports
Medicine, located both at the Island Health Center and Cayuga Medical
Center’s Convenient Care Center. We offer aquatic therapy at Island
Health and Fitness.
Frequently Asked Questions
How long does the joint
The components of the
artificial joint last an average of fifteen years, depending on the activity
level of the patient. Our surgeons specialize in selecting the optimal
components for the activity level and age of each individual patient. Our
surgeons also specialize in total joint replacement revision surgery, if
What are the components
Total joint replacement
components may be made of plastic, metal (including cobalt chrome and titanium),
or ceramic materials.
How can I best prepare for
joint replacement surgery?
The Joint Solutions
pre-operative education class outlines how you can best prepare for the surgery
and includes information on appropriate exercise, home safety, and arrangements
for a post-operative support network.
What are the risk factors
for total joint replacement surgery?
Most surgeries occur
without any complications. However, the risk of infection and blood clots
concern us the most. Antibiotics, blood thinners, and early mobilization assist
in preventing these complications.
How much pain will I have?
Many patients have
suffered with painful arthritis leading up to the surgery. The pain experienced
after total joint replacement surgery is temporary and will diminish over the
first few weeks following the surgery. It’s important to keep your
post-operative pain under control to allow you to exercise and walk. The staff
will work with you to keep you comfortable.
How long until I am back
The average hospital
length of stay is four days, followed by home care and outpatient therapy as
needed. Recovery times vary; however, most patients return to driving and work
activities four to six weeks after surgery.
For more information on our Joint Solutions Program click here.
Make an appointment with an Orthopedic Specialist:
Orthopedic Services of CMA
16 Brentwood Drive, Suite A - Parkview Campus
Ithaca, NY 14850
For more information on our Orthopedic Services click here.
Plastic, Cosmetic, and
Our surgical specialists
are fellowship-trained and very experienced. They perform both facial plastic
surgery and reconstruction following surgery for cancer and trauma. They
operate at Surgicare and Cayuga Medical Center, routinely handling:
and nasal surgery, both reconstructive and cosmetic
after the excision of tumors
(breast reconstruction) and TRAM flap or transverse rectus abdominus
myocutaneous flap (breast reconstruction with skin
and fatty tissue from the patient’s abdomen)
surgery, including the reattachment of severed fingers; endoscopic carpal
tunnel surgery; nerve surgery and other forms of microsurgery
to remove fat and contour the body
newest techniques for chronic wound care
Podiatry: Surgery for the
Our podiatrists perform a number
of surgical procedures to correct painful foot problems.
of toe joints deformed by bunion, joint implants, and bone fusion
surgery to alleviate pain and callous formation
the realm of soft tissue surgery, they treat neuromas
(pinched nerves), tarsal tunnel release, soft tissue tumors (cysts and
ganglions), plantar fasciotomies
and laser wart removal
therapy to treat heel pain
Urologists at Cayuga
Medical Center provide medical and surgical treatment for diseases of the
urinary tract in women and men, and the reproductive tract in men. They offer
the newest approaches for treating bladder cancer and take care of patients
for male infertility
and surgical treatment for erectile dysfunction
and surgery to correct undescended testicles in young
and surgical treatment for incontinence in women related to childbirth
invasive lithotripsy to break up painful kidney stones from outside of the body
using shock waves, with no cutting or incision involved (patients are able to
return home the same day)
Vascular Surgery Addresses
Vascular disease affects
the circulation of blood in the arteries and veins. The vascular surgeons at
Cayuga Medical Center reopen blocked and narrowed blood vessels using minimally
invasive endovascular techniques for much of the surgery they do.
repair of abdominal aortic aneurysm (AAA) eliminates the need for a large
abdominal incision and significantly reduces the time required in the hospital
and for post-operative recovery
entire range of blood vessel surgery, including angioplasty, stenting, and bypass surgery
endarterectomy (to remove plaque buildup from the
inside of the carotid arteries) and other advanced vascular procedures,
including renal artery angioplasty and stenting
venous-disease expert (phlebologist) treats varicose
veins using a new minimally invasive approach called the Endo Laser Venous
System (ELVS), which allows patients to return to normal activities the