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All Posts in Category: Minimally Invasive Surgery

Stereotactic Breast Biopsy: Minimally Invasive Cancer Screening Care

In the fight against breast cancer, it may be reassuring to know that they are many effective screening tests in regular use today. When a routine mammogram detects an abnormality, including calcifications within the breast, your doctor may order a biopsy to further aid in diagnosis.

Which Biopsy For My Situation?

There are different types of breast biopsies, and your doctor will choose the biopsy best suited for your care. Generally the type of biopsy used depends on whether a lump can be felt, or if a previous mammogram showed a change within the breast. In many cases, however, a minimally invasive stereotactic breast biopsy may be utilized for its many benefits.

A stereotactic biopsy is an x-ray based, image-guided process that assists the doctor in pinpointing the area of concern, from which a small tissue sample is collected for examination and final diagnosis.

What Can I Expect?

When making your appointment for a biopsy, it’s always a good idea to ask how long the procedure is expected to take. As with any procedure, it may be comforting to have a friend or family member accompany you to the appointment and wait for you until the procedure is completed. For the procedure you’ll either lie down or sit upright, depending on the imaging equipment used.

Just like a mammogram, on the day of the biopsy don’t wear perfume, deodorant, lotion, or put anything else on your skin. This is so the imaging equipment will be able to accurately view the area of concern. A numbing agent will be used on the breast area so you won’t feel any pain. Again just like a mammogram, the breast is compressed between two plates to x-ray the targeted area. A small tissue sample is then taken for examination.

How Soon Can I Go Home?

A stereotactic breast biopsy is a minimally invasive procedure, so unlike surgical biopsies that require an overnight stay, you are able to go home shortly after the procedure is finished. Once home, you may want to take it easy for 24 hours. Your doctor will provide additional self-care instructions as needed, as well as provide biopsy results once they are available. At all times, you are encouraged to ask as many questions as needed to fully understand the procedure, as well as what to expect both during and after.

Providing complete breast cancer screening, surgery and treatment services, Dr. Joseph Levan, Dr. Robert Howard and Dr. Thomas Beetel of Spring Ridge Surgical Specialists perform stereotactic breast biopsies at Reading Health System, and Penn State Health St. Joseph. Each of our surgeons take pride in making certain patients fully understand their care, and options available to them. If you have any questions pertaining to breast cancer care, please contact Spring Ridge Surgical Specialists at 610.375.0500.

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Colorectal Cancer Screenings: Take Time to Put Yourself First

Possibly the biggest gift we can give ourselves is time. Time to smell the flowers, go for a long walk or just enjoy a laugh with friends. In our hectic lives, it’s easy to put ourselves last and not take the time we need to check in on our personal health. Even easier is to avoid taking a first step to what we know will help us in the long run. “I can do it tomorrow”, “I feel fine”, “I don’t have the time right now” are common roadblocks we might use to convince ourselves that routine health screenings just don’t fit into our busy lives right now.

Why and When to get Screened for Colorectal Cancer

At Spring Ridge Surgical Specialists, we consult with many patients who come to us hesitant to take the first step in screening for colorectal cancer, one of the most prevalent cancer types in the United States today. It’s important to point out that colorectal cancer often does not produce any symptoms until the disease is in the advanced stage. Whether referred by a family doctor, a family history of colorectal cancer, or having reached the suggested age of 50 to begin screenings, it’s natural to have many questions – some perhaps difficult or embarrassing to ask – but so important as you take an active role in your colorectal care. In this article, we’ll share basic information on the types of screenings and what you might expect with each.

What You Can Expect

The goal of any screening is to detect polyps within the gastrointestinal tract. Your doctor will discuss the screening method best for your individual health needs. If detected, the majority of polyps is usually non-cancerous and not cause for concern if promptly removed. Lab testing of the removed polyps will confirm if cancer is present or not.

  • Colonoscopy is the best test available today that doctors can utilize to detect the presence of polyps and remove them during this minimally invasive procedure.  A day before your procedure, bowel prep will need to be performed at home. During the painless procedure, you will be sedated, asleep and completely comfortable. A long, flexible tube will be inserted and guided throughout the entire colon, producing images the doctor will see on a video monitor to determine if polyps are present.
  • Digital Rectum Exam (DRE) is a painless exam your doctor performs in the office to detect polyps in the rectum or anus.
  • Fecal Occult Blood Test tests for blood in the stool that can’t be seen, but if present may indicate polyps or cancer.

Regardless of the screening method your doctor recommends for you, it’s important to ask as many questions as necessary so you fully understand the procedure. Dr. Robert Howard, Dr. Joseph Levan, and Dr. Thomas Beetel each take pride in educating patients on the benefits of colorectal cancer screenings, and what to expect during a screening procedure.

Most importantly, as an informed patient you have the power to take time for yourself and maintain your best health!

– Spring Ridge Surgical Specialists

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Computer tablet with the words "Acid Reflux" appearing on screen

Barrett’s Esophagitis: A Condition Caused by GERD

GERD and its Impact on the Esophagus

As we shared in other posts, GERD (short for “gastroesophageal reflux disease”) is the culprit in creating heartburn, the painful burning sensation felt in the throat and chest after eating certain foods.  It is estimated that approximately seven million people in the United States, from adults to infants, suffer from the symptoms of GERD at some point in their lives. For many people, the affects of GERD are felt only occasionally such as after a very large meal (think Thanksgiving). But for some who suffer from heartburn on a regular basis, GERD can cause other conditions if left untreated. One such condition this post will discuss is Barrett’s Esophagitis.

When GERD occurs, acidic fluids from the stomach flow backwards, or reflux, up into the esophagus. These caustic fluids irritate the lining of the esophagus, creating the burning sensation commonly referred to as heartburn. Repeated bouts of GERD over an extended period of time can damage the lining of the esophagus, creating a condition called Barrett’s Esophagitis. Although not cancerous itself, the presence of Barrett’s Esophagitis indicates the lining of the esophagus has been changed enough that cancerous cells could develop.

How Barrett’s Esophagitis is Detected

In many cases, Barrett’s Esophagitis is detected during routine diagnostic evaluation for GERD via an upper endoscopy. During this minimally invasive procedure, a small flexible tube with a video camera is used so the surgeon can perform a visual analysis of the affected area.   In a healthy esophagus, the lining is pink and uniform in color. With an esophagus affected by Barrett’s Esophagitis, the lining appears uneven in color and pattern, as seen in this side by side comparison:

Barretts comparison

If Barrett’s Esophagitis is present, your surgeon may need to perform additional testing such as biopsies to detect the presence of pre-cancerous or cancerous cells within the esophagus.

Preventing Further Damage from Barrett’s Esophagitis

Your surgeon will keep track of any changes in your esophagus through regular testing. The good news is that controlling the symptoms and potential esophageal damage from GERD is often achievable with lifestyle changes your surgeon can suggest specifically for your condition. These can include losing weight, avoiding smoking and alcohol, and eliminating greasy and high-fat foods that create reflux.

Dr. Thomas Beetel, Dr. Robert Howard, and Dr. Joseph Levan of Spring Ridge Surgical Specialists each provide evaluation of GERD and Barrett’s Esophagitis. With offices located at 2758 Century Boulevard, Suite 1, Wyomissing, PA., many procedures are performed at the adjacent Surgical Institute of Reading. To make an appointment to see Dr. Beetel, Dr. Howard, or Dr. Levan, please call 610.375.0500.

– Spring Ridge Surgical Specialists

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Picture of Dr. Robert Howard, Dr. Joseph Levan and Dr. Thomas Beetel of Spring Ridge Surgical Specialists

The Three Best Questions to Ask Your General Surgeon Before Surgery

Taking An Active Role in Planning For General Surgery

As consumers, it’s very much second nature for us to gather and sort through masses of information on countless products and services, choosing the one we think will work best.   When taking on the role of patient, however, sometimes there is a hesitancy to ask questions about concerns that could have a major impact on our health. If you can relate to the feeling of “I should’ve asked”, Spring Ridge Surgical Specialists would like to offer three of the best questions to ask your surgeon prior to general surgery.

Discussing General Surgery’s Surgical Methods

First, of course, is asking about the type of surgery and surgical method that will be utilized. Used to treat many conditions within the abdomen, including the colon and hiatal hernias, minimally invasive laparoscopic and robotic surgery uses keyhole-sized incisions to access and address areas of concern. As we shared in a previous post, What Is Minimally Invasive Surgery?, the advantage of minimally invasive laparoscopic and robotic surgery is a much quicker recovery period when compared to traditional open surgery with its large incision and lengthy recovery.

Become Familiar with Your Hospital

The second question to ask your general surgeon prior to surgery is equally important. Just as you select a surgeon based on comfort level and expertise, it’s best to become familiar with the surgical hospital where your surgeon will perform your procedure. Typically, surgeons are affiliated with specific surgical hospitals, so when you choose your surgeon, you are in effect also choosing the surgical hospital where your procedure will occur. Ask your surgeon what advantages the surgical hospital offers, compared to others in the area, so you have confidence in where your surgery will occur. In our practice, surgeons Dr. Thomas Beetel, Dr. Robert Howard, and Dr. Joseph Levan perform minimally invasive endoscopic, laparoscopic and robotic procedures at Surgical Institute of Reading, including laparoscopic treatment of incisional and inguinal hernias, reflux, as well as conditions of the colon and gallbladder.   Our practice is also affiliated with and performs procedures at Penn State Health St. Joseph and Reading Health, respectively.

For Your Health’s Sake, Ask Away!

Lastly, ask questions about what you can expect during your recovery period after surgery. How long will you stay in the hospital after surgery? Will you need to be driven home by a friend or family member after surgery? Will someone need to assist you with your personal care during recovery? How soon will you be able resume regular activities, including returning to work? Knowing the answer to these and other questions prior to surgery can make all the difference in having a positive surgical experience and outcome.

To Your Best Health,

Spring Ridge Surgical Specialists
2758 Century Boulevard, Suite 1
Wyomissing, PA 19610

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Dr. Thomas Beetle of Spring Ridge Surgical Specialists

Dr. Thomas Beetel to speak at Surgical Institute of Reading


Questions about GERD (Heartburn), Hiatal Hernias and Anti-Reflux Surgery?

Join Dr. Thomas Beetel at Surgical Institute of Reading as he presents:

“The Truth About Heartburn and Hiatal Hernia: When Do You Need Surgery?”.

When: Wednesday, March 30th at 5:30pm

Where:  Surgical Institute of Reading   2752 Century Boulevard  Wyomissing, PA  19610

To RSVP:  Please call 610.375.0500 by March 29th.  Reserve your seat by calling today!

There will be plenty of opportunities for questions during the presentation.

About Dr. Thomas Beetel
Dr. Thomas Beetel of Spring Ridge Surgical Specialists specializes in minimally invasive surgery, including laparoscopic procedures of the colon, esophagus and gallbladder, as well as laparoscopic hernia repair. His practice offices are conveniently located next to Surgical Institute of Reading in Wyomissing, PA.


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Hernia repair surgery video

This brief video shows a minimally invasive laparoscopic hernia repair surgical procedure, performed by Robert J. Howard D.O., F.A.C.S. of Spring Ridge Surgical Specialists.

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A Burning Issue: Gastroesophageal Reflux Disease

Many of us have occasionally experienced heartburn (which to clarify, has nothing to do with the heart), whether after Thanksgiving dinner or by lying down too soon after eating. If repeated bouts of “heartburn” or sour-tasting fluid in your throat have affected you, however, these are typical symptoms of a common health issue called gastroesophageal reflux disease (“GERD”), also referred to as reflux.

GERD is caused by acid escaping from the top of the stomach through a weakened one-way valve, and flowing backwards as far as the throat. To help ease symptoms, non-operative treatment such as the use of over-the-counter antacids, increasing exercise, placing a foam wedge at the head of the bed and prescription medication can be effective. If these and any other methods recommended by your physician do not provide relief, it may be necessary to consider surgical correction of this very manageable condition.

Surgical Care to Relieve GERD

GERD indicates the one-way valve between the esophagus and the stomach, called the lower esophageal sphincter (“LES”), is weakened and requires structural support. The condition can occur in patients of any age, from infants to mature adults.

Correcting GERD means repairing the LES. Typically repaired by minimally invasive laparoscopic surgery, surgeons recreate the LES by wrapping the very top of the stomach around the lower part of the esophagus. This correction allows the LES to close immediately after food passes through to the stomach, keeping acids intact.

Recovery from LES Surgery

Most LES repair surgeries occur via minimally invasive laparoscopic surgery. As we’ve shared in the previous blog What Is Minimally Invasive Surgery?, this type of surgery helps patients leave the hospital and return to work sooner due to the small keyhole incisions made during the procedure. Generally, when LES repair is performed via minimally invasive laparoscopic surgery, patients can expect to go home 1 to 3 days after surgery and return to work within 1 to 2 weeks.

Steps You Can Take

If you have any of the symptoms we’ve described and think you may have GERD, contact our office to schedule a complete diagnostic evaluation and discuss both medical and surgical options for effective treatment. Dr. Robert Howard, Dr. Thomas Beetel and Dr. Joseph Levan are all experienced with both workup and treatment of GERD. CLICK HERE to request an appointment online or call our office at 610.375.0500.

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Laparoscopic Colon Surgery: Treating Diverticulitis and Inflammatory Bowel Disease

As discussed in one of our previous blog posts, Colon Cancer Surgery: Two Techniques to Ensure Best Outcomes, colon issues can often be treated by minimally invasive surgical procedures called laparoscopy.
Laparoscopy is the use of small keyhole incisions to access a surgical site. Using a very small video camera, a surgeon identifies causes of pain or discomfort and treats the condition accordingly. In addition to colon cancer, laparoscopic surgery is used to treat common issues of the colon such as diverticulitis and inflammatory bowel disease (IBD).

Diverticular Disease

In its healthiest state, the lining of the colon is smooth in texture. Sometimes, small, balloon-like pouches form within the walls of the colon. Since the colon’s main job is to help expel waste out of the body, it is generally believed the pouches appear as a result of a low-fiber diet. The pouches indicate a condition called diverticulosis. Very uncommon among individuals under 40 years of age, diverticulosis is prevalent in approximately half of the population aged 60 years of age and older. Often, patients do not experience any pain or discomfort with diverticulosis, and the condition is only discovered due to routine testing such as a colonoscopy. In many cases, diverticulosis is effectively treated with medication and increasing fiber intake.

In cases where the pouches become inflamed or infected, however, a condition called diverticulitis occurs. Patients may experience abdominal pain, fever, cramping, and constipation, among other symptoms. Initial treatments can include antibiotics, but in recurring or severe cases, the use of surgical treatment may be required. In treating diverticulitis, minimally invasive laparoscopic surgery is used to remove the affected sections of the colon.

Inflammatory Bowel Disease

Like diverticulitis, inflammatory bowel disease (IBD) causes the lining the colon to become inflamed and irritated. Two types of IBD include Crohn’s disease and ulcerative colitis. Even though the symptoms of both are similar, the areas affected in the gastrointestinal tract are much different.

With Crohn’s disease, inflammation can occur at intermittent sections of the entire gastrointestinal tract and is not limited to the colon. Conversely, with ulcerative colitis, inflammation is limited to the colon.

Surgical Treatment 

When diverticulitis or inflammatory bowel disease need to be surgically managed, laparoscopic surgery offers the best of both worlds – effective treatment with minimal incisions. Treating these conditions proactively can help avoid the possibility of emergency surgery, which could result in the need for a temporary colostomy pouch. Laparoscopic surgery decreases recovery from a couple months to a couple weeks.

Dr. Joseph Levan, Dr. Thomas Beetel, and Dr. Robert Howard, each Fellows in the American College of Surgeons, provide laparoscopic surgical care for the colon. When you have questions about preventative and surgical care of the colon, make an appointment to see one of our providers by CLICKING HERE.

– Spring Ridge Surgical Specialists


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Colon Cancer Surgery: Two Techniques Ensuring Best Outcomes

As discussed in one of our previous blog posts, When to Have a Colonoscopy, the American Cancer Society states colorectal cancer is the third most common cancer for men and women in the United States today. With this high rate of cancer diagnosis, much emphasis is placed on best methods to surgically treat colon cancer to ensure best possible patient outcomes.

When receiving a colon cancer diagnosis, your surgeon is the best resource for answering the many questions you will naturally have in mind. The first question many patients have is in regards to the surgery itself. Today, there are two types of surgeries commonly used to manage colon cancer. Open surgery, the more traditional surgical technique, refers to the process of creating a large abdominal incision to access and treat the cancerous site. Laparoscopic surgery is the minimally invasive alternative to open surgery. With laparoscopic surgery, three or four small keyhole incisions are utilized along with a very small, flexible tube outfitted with a video camera to enable surgeons to clearly see the cancerous site and manage it as needed.   Sometimes, the images seen during a laparoscopic procedure require surgeons to convert to open surgery to effectively treating the cancerous site. Your surgeon will determine the surgery technique best suited to your care needs, factoring in information such as prior surgeries and other medical information. Above all, as a patient you should feel comfortable asking any questions necessary to fully understand your care options. When in doubt, ask!

At Spring Ridge Surgical Specialists, Dr. Joseph Levan, Dr. Thomas Beetel, and Dr. Robert Howard all take pride in having thorough discussions with patients prior to and after colon cancer surgery. With a combined 45 years of experience in treating colon cancer, Dr. Levan, Dr. Beetel, and Dr. Howard offer superior care in all phases of colon cancer management needed for your best possible outcome. Click here to make an appointment today.

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Multi-generational family portrait

Hernia Repair – Today’s Surgical Advancements

Hernia Repair – Much Easier Now Than in the Past

Decades ago, a hernia diagnosis meant the need for open surgery, resulting in large incisions and scaring, a typical postoperative hospital stay of several days and an uncomfortable recovery period of up to several weeks. These conditions meant patients were not able to return to work quickly as desired, as well as a lengthy timeframe of limited physical activities. Understandably, patients were often reluctant to seek surgical treatment for hernia repair knowing what would likely lie ahead. Oh, how times have changed!

Today’s Hernia Repair Surgery – Definitely Not Your Father’s Hernia Surgery

With the development of laparoscopic minimally invasive surgery specifically addressing hernias in the 1990’s, surgical repair of the condition became much more accessible, manageable and above all, presented faster recovery periods for patients. This is attributable to laparoscopic surgery’s small “keyhole” incisions, placed strategically on the abdomen to both maximize access to the affected area as well as minimize recovery periods due to smaller incisions. In fact, in most cases patients can walk out of the hospital the same day as their procedure, experience much less postoperative pain and can be back to work in just a week or two. Unfortunately, however, the perception persists that hernia surgery means patients have to put life on hold for weeks. This is simply no longer the case.

By the Numbers

It is estimated that approximately 10 percent of the population is confronted by some type of hernia issue throughout their lives. Hernias impact all age groups, including infants, children, teenagers and adults. Each year, approximately 500,000 hernia surgeries are performed in the United States, but it is suspected that an even larger number of patients suffering from hernias delay treatment hoping the issue will go away on its own. The reality is, however, hernias do not repair themselves and if left untreated, severe cases can progress to the point where patients can find themselves in the emergency room.

Getting Back to an Active Life

The good news is that proper treatment and recovery from hernias is very achievable when discussed with a primary care physician or surgeon upon discovery of possible hernia-related abdominal pain or bulging. After a typically brief postoperative recovery period, it is common for patients to feel like themselves in just a couple weeks.

Dr. Thomas Beetel and Dr. Robert Howard of Spring Ridge Surgical Specialists specialize in laparoscopic hernia repair. If you have questions and wish to request an appointment online, CLICK HERE.

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