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A less traumatic surgery Mail Tribune photos / Bob Pennell Dr. David Street, left center, and Dr. David Traul, right center, keep an eye on television screens as they repair an abdominal aortic aneurysm on their patient, Tom Jones, at Rogue Valley Medical Center Wednesday. Medford surgeons are using a new technique that is far less dangerous than traditional open surgery and allows quick recovery for the patient. Medford surgeons among state�s first to use technique to repair arteries By Bill Kettler Tom Jones should have been in a hospital bed today with an angry scar on his stomach. But he�s relaxing at home, recovering from two small incisions in his groin. The 57-year-old Medford man walked out of Rogue Valley Medical Center on Thursday, less than 24 hours after surgeons repaired an artery deep inside his belly. Just a few months ago, physicians would have opened Jones� abdomen to repair a weakened section of his aorta, the main artery that distributes blood from the heart. Surgery like that used to keep patients hospitalized for a week or more. But a new technique allows doctors to repair abdominal aortic aneurysms by inserting a "patch" through smaller arteries in the groin. Patients recover faster because the new surgery is far less invasive than the traditional "open" surgery, said Dr. David Street, one of three Medford surgeons who perform the surgeries. "This is the biggest leap forward in how patients recover in a long time," Street said. "You see them in the office (after surgery) and you wonder why they�re there because they�re doing so well." Street and two colleagues, Dr. David Traul and Dr. William Faught, are among the first surgeons in Oregon to use the new "endoluminal stent graft" technology. Jones� was their 17th surgery, more than twice the number of all others (seven) performed in Oregon hospitals since the technique was released for general use last October. Street and Traul repaired Jones� aortal aneurysm on Wednesday. They made two 2-inch incisions in his groin to reach arteries that descend from the aorta. Working on one leg at a time, they inserted a thin guide wire into the artery, then slid a flexible, hollow tube into the artery on the wire. After removing the guide wire from the catheter, they inserted pieces of hollow-wire-mesh-and-polyester tube and set them in place with a crank that looks like a fishing rod. Street likened the mesh tube to a Chinese finger trap. Made from a heat-sensitive alloy, the wire mesh slowly expanded to fill the artery�s inner wall. The fabric liner created a sleeve inside the weakened artery to prevent it from rupturing. Physicians have used stents for more than a decade to keep clogged arteries from collapsing. Street, Traul and Faught use technology originally developed in Argentina to keep swollen arteries from bursting. The stent grafts Street and Traul use were developed by Medtronic, a California-based medical technology company that sells them under the AneuRx trade name. Medtronic offered the new technology to the Medford surgeons "because they had the necessary skills to utilize the technology we offer," said company representative Gary Wilkins. Street said the procedure requires different skills than the usual hand-eye coordination that surgeons bring to the operating room. In this surgery, Street sees inside a patient�s body by looking at a screen that shows X-ray photos of the patient�s abdomen while he guides wires, catheters and stent grafts into place. "It�s different in that it�s not stuff you touch and you feel and you see and you move," he said. "You lose a lot of the three-dimensional feedback when you work in two dimensions. It�s like operating in a box. "You go from a three-dimensional object you can feel and touch to working on a TV screen." While the procedure requires physicians to learn new skills, it�s far less dangerous for patients. In the old technique, doctors clamped the aorta while they sewed a patch on it. "One of the most common and severe complications," said Street, "was a heart attack." Most people who need the surgery have major health problems and don�t need the extra stress of a heart attack. Jones, for example, has had two open-heart surgeries and a bypass operation. "Just the word �aneurysm� scares the hell out of me," the retired concrete-truck driver said. "Sooner or later they burst." An aneurysm can develop in any blood vessel, but a ruptured aorta can be a death sentence. Street said people who suffer a burst aorta need to reach a hospital within an hour to have any chance of surviving. Of those who do, only about half survive surgery to repair the damage. Besides saving lives, the new process saves patients money. Although the stent grafts are expensive (about $10,000), patients avoid the long recovery time, which often included several days in intensive care. On average, patients who had the traditional open surgery incurred hospital bills of about $29,000, said RVMC spokeswoman Leslie deSchweinitz. Patients who have the new surgery pay about $4,000 less. Hours after his surgery on Wednesday, Jones said he felt "pretty good." He was stiff and sore when he left the hospital Thursday morning, but he could walk around his home in the afternoon and show a visitor a porch he built last summer. "If this would have happened three years ago," he said, "it would have been a major surgery for me. This is a better way to go." 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