Spyglass Direct Visualization System

DDAR Physicians are using cutting edge new technology at Good Samaritan Hospital to aide in the diagnosis and treatment of gallstones, liver disease and certain types of cancer.  This exciting new technology from Boston Scientific is the Spyglass Direct Visualization System or Spyglass for short. The Spyglass technology provides our physicians with a powerful tool to get enhanced visibility of the pancreas, liver and gallbladder so that they can make a more accurate diagnosis of the patient’s condition.  It is particularly useful in identifying gallstones, hepatic strictures and lesions that may be cancerous.   Spyglass is used while the patient undergoes an ERCP, Endoscopic Retrograde Cholangiopancreatograpy Procedure.

Dr. Vipul Shah noted that the Spyglass uses a tiny fiber optic wire and camera to locate the gallstone.  This is particularly useful in cases where there are multiple stones hidden in the bile duct.  The technology can be combined with a probe that emits pulse waves to break the stones  into smaller pieces, that can be more readily removed and without subjecting the patient to major surgery. 

Dr. Yaron Langman further commented that in the past the only option for detecting cancer was a blind swipe with a brush which resembles a pipe cleaner.  The test was only effective 65 percent of the time, which often delayed patient treatment.  Now, with the Spyglass system, the gastroenterologist can see the lesion and using the SkyBite Biopsy forceps take a biopsy thus increasing the likelihood of obtaining an accurate diagnosis with the goal of expediting the patient’s treatment when required. 

Spyglass technology is just one of the exciting new treatment modalities which utilize nanotechnology and enhanced optics to diagnose and treat many GI ailments and complaints.  Please stay tuned to future blogs wherein we will showcase other cutting edge technology in development.   

New York State Health Exchange

On August 20, 2013, The State Health Commission of New York, Dr. Nirav R. Shah announced the official name of the New York Health Benefit Exchange Marketplace and many of health plans to be offered.  “NY State of Health will be the official market place for individuals and small groups in New York State to purchase health and dental plans under Obama-care also known as the Affordable Care Act.  On October 1, 2013, NY State of Health will begin enrolling for the January 1, 2014 through December 31, 2014 coverage period. 

Health plan options to be offered by “NY State of Health” included individual and small group plans from the following health insurance companies:

  • Affinity Health Plan
  • America  Progressive Life & Health Insurance Co of New York
  • Capital District Physicians Health Plan (CDPHP)
  • Emblem Health – Health Insurance Plan of Greater New York.
  • Empire Blue Cross & Blue Shield
  • Fidelis Care
  • Frrelancers Co-Op
  • Healthfirst
  • Independent Health
  • MetroPlus Health Plan
  • MVP Health Plan
  • Nothshore LIJ
  • United Healthcare of New York, Inc. (United, Oxford)

Plans will be offered in four tiers (platinum, gold, silver and bronze).  All plans sold on the “NY State of Health” Marketplace will cover doctor’s visits; hospital stays; emergency care; maternity & newborn care;  mental health services; prescription drugs; rehabilitative care, laboratory testing; preventative and chronic disease care; etc.   Deductibles, co-insurance and co-pay amounts will vary by tier selected. Individuals and families with incomes below certain levels ($45,960 for individuals and $94,200 for a family of four are eligible for financial assistance in the form of federal tax credits which are only available through “NY State of Health”.  Federal tax credits limit the amount a person pays for insurance each month.  Monthly payments will be significantly below the cost of buying insurance in today’s marketplace.  Individuals cannot be excluded because of laps in previous coverage and prior medical conditions.  For more information, visit the NY State of Health website at nystateofhealth.ny.gov. 

Irritable Bowel Syndrome

Everyone experiences discomfort in their gut from time to time. It can occur when we are nervous about something, or when we eat something that doesn’t agree with us. But if you regularly feel pain in your abdomen, it might be a sign of a disorder called irritable bowel syndrome (IBS).

Irritable bowel syndrome affects about 1 in 5 Americans, and occurs more often in women than men, and usually begins before the age of 35.

There’s no medical test to identify irritable bowel syndrome. Your doctor may make a diagnosis based on the patient’s symptoms and through exclusion of other problems. The most common IBS symptoms include bloating and pain in the abdomen, along with changes in bowel habits. People with irritable bowel syndrome may have constipation, diarrhea or both.

IBS doesn’t lead to cancer or other health problems, but the discomfort it causes can be difficult to live with. No one really knows what causes irritable bowel syndrome yet everyone agrees stress plays an important role in triggering symptoms.  Stress reduction strategies can help relieve these symptoms.

Some researchers suspect that IBS can be caused by a change in bacteria in the digestive tract.   Digestion is aided by helpful bacteria, but sometimes the bacteria in our gut can change, especially after taking certain medications. We often suggest a supplement of probiotics to aid digestion and reduce IBS symptoms. Probiotics are available as capsules, tablets and powders, and they’re found in some dairy foods, such as yogurt. The benefits of probiotics is still however under investigation.

Many people with irritable bowel syndrome find that certain foods can make them feel worse. Irritable bowel syndrome patients are generally more sensitive to a variety of foods.  Some researchers believe a diet low in Fermentable Oligo, Di & Mono-Saccharides and Polyols (FODMAP) may help eliminate chronic bloating and gas.  We recommend patients keep a diary of the foods they eat and how they make them feel so that they can share this information with their doctor.

Every case of irritable bowel syndrome is unique, so if you have symptoms that disrupt your life, don’t suffer in silence. Your doctor can work with you to find the treatment that works best for you.



Cyclospora Outbreak

During the summer, many people tend to eat lighter and consume more salads.  To that end, we wanted to alert you to a recent outbreak of an intestinal illness that may be attributable to eating prepackaged salad.  The Center for Disease Control (CDC) is working diligently with local health departments in several states to determine the possible link between a Cyclospora outbreak and bagged salad mix sold across the country.  Hundreds of people have become ill  and 22 people in five states have been hospitalized over the past several weeks. 

Cyclospora is an intestinal illness caused by a microscopic parasite Cyclospora cayetanensis.  The disease is transmitted by fecal matter ingested in foods or water supply.  Symptoms can include loose, water diarrhea, fatigue, bloating, stomach cramps, nausea and low grade fever.  Public health workers in several states have noticed that a large number of the afflicted had eaten the same brand of prepackaged salad mix.  CDC and public health officials are also investigating salad mix sold to patrons of a large national restaurant chain where they have identified clusters of Cyclospora outbreaks. The national restaurant chain purchased its salad ingredients for a single source. 

We recommend that you thoroughly wash all lettuce and vegetables before consuming them, even if your prepackage salad mixes are labeled as pre-washed. 

We would also like to remind you to use precaution when swimming in local lakes and ponds this summer.  Outbreaks of intestinal illness due to waterborne parasites such as Giardia occur in water supplies that are home to water fowl like ducks and geese.  Check with local officials to make sure that your lakes and ponds have been properly treated and inspected before jumping in.  





The following is reprinted from the CCFA March 11, 2020 email blast to their provider network. 

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