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Sialendoscopy for Salivary Gland Obstructions Now Available at University Medical Center

NEW ORLEANS, LA – Sialendoscopy and a comprehensive array of salivary gland interventions are now available for the first time at University Medical Center New Orleans. Sialendoscopy is a minimally invasive procedure that treats obstructions in the salivary glands and inflammatory conditions and can greatly improve patient outcomes and recovery times.

The procedure combines salivary endoscopic guidance – with or without open surgical procedure – and robotic surgery. Patients who undergo the operation experience less blood loss, less scarring and a shorter hospital stay, as compared to other procedures. They also avoid the complications of traditional open surgery, including nerve damage, scarring and loss of a functional salivary gland.

Sialendoscopy procedures at University Medical Center are performed by our own Rohan Walvekar, MD, an Associate Professor and the Mervin L. Trail Endowed Chair in Head and Neck Oncology within the Department of Otolaryngology Head and Neck Surgery at Louisiana State University Health Sciences Center New Orleans.

Dr. Walvekar describes the procedure as a “paradigm shift in the management of salivary gland diseases.”

The approach is one that aims to visualize the interior of the salivary ducts and to repair the problems in them. It involves the use of specialized dilators to gently stretch open the ducts.

In the past, doctors have had to treat patients conservatively with medication or other techniques, including surgery, often providing relief but not mitigating the underlying problem.

Traditionally, large stones in the salivary glands have required complete removal of the salivary gland, Dr. Walvekar said. “Now we can now use small endoscopes to enter the ducts of the salivary glands and remove stone with these miniature endoscopes or their assistance – this allows us to keep the glands intact in over 95% of patients.”

Dr. Walvekar, also Director of the Salivary Endoscopy Center, is now an internationally and nationally recognized expert in his field. In 2010, he became the first surgeon in the world to successfully combine salivary endoscopic guidance with use of the da Vinci robot to facilitate access to large stones in the back of the mouth.

The technique that he pioneered is now being widely used to treat salivary duct obstructions and has become a more preferred approach than conventional gland removal procedures.

 “Traditional surgery to remove the gland is not trivial and can have major side effects,” Dr. Walvekar said. “One of the major complications of salivary gland surgery is a risk to the facial nerve that can cause facial paralysis – probably the most notable complication among others that can occur, such as infection, bleeding, facial deformity and surgical scar.”

To add to his list of achievements, Dr. Walvekar also developed a salivary duct stent –“Walvekar Salivary Duct Stent”— manufactured by Hood Laboratories in Pembroke, MA, that is being used across the country by surgeons to prevent future problems in the salivary ducts.

“If you have to make a cut into the duct to remove a salivary stone, the duct may heal abnormally,” Walvekar said. “The stent just provides a scaffolding for the duct to heal appropriately.”

Dr. Walvekar recently performed his first sialendoscopy at University Medical Center, successfully removing five stones from a patient, who, according to the doctor, would have likely required gland removal surgery if sialendoscopy were not available to the patient.

“Thanks to the continued support of my department chair – Dr. Daniel Nuss, our faculty, staff and residents within the LSU Department of Otolaryngology at LSUHSC, I have been able to develop a center that provides a comprehensive array of procedures that help with salivary gland preservation, including sialendoscopy,” Dr. Walvekar said.

“Now, thanks to the vision and support of our CEO, Mr. Bill Masterton and leadership at UMCNO and LCMC Health, we are able to offer this unique procedure in a comprehensive fashion, to patients within the Greater New Orleans area,” he added.

“We are looking forward helping patients who are referred to us with salivary stones, recurrent swellings, or even those patients in whom the cause of salivary gland swelling may be uncertain since our scopes are not only used for treatment but also diagnosis.”

To schedule an appointment with Dr. Walvekar at University Medical Center, call (504) 702-5700.

About University Medical Center New Orleans

Opened in August 2015, University Medical Center New Orleans is the academic medical center of LCMC Health, a Louisiana-based, not-for-profit health system. University Medical Center New Orleans serves as a key partner of LSU Health Science Center New Orleans, Tulane University School of Medicine and other academic institutions. University Medical Center is home to the Rev. Avery C. Alexander Academic Research Hospital, named in honor of the respected Civil Rights and community leader who served in the Louisiana Legislature for more than 20 years.v

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