Top doctors: The virtual colonoscopy
A "virtual colonoscopy" certainly sounds tolerable, compared with the traditional kind. "People think it's magic," said Great Neck surgical oncologist Dr. James Sullivan III.
Truth be told, however, virtual colonoscopies are quite similar to the traditional procedure, even down to the preparation that so many dread. Here's what you should know:
1. THEY'RE UNPLEASANT
Virtual colonoscopies detect polyps in the colon with the help of three-dimensional CT scans instead of scopes that are inserted into the rectum. But the preparation is the same. Prospective patients must clear their bowels before the procedure, typically by drinking a laxative solution and staying near the toilet.
"That's the worst part of the exam, and you have to do it for both types of colonoscopy," said Sullivan, who's board-certified in colorectal surgery.
In addition, a virtual colonoscopy includes having air pumped into your intestines -- a procedure Sullivan likened to an "air enema."
2. YOU STILL MIGHT NEED A TRADITIONAL COLONOSCOPY
The purpose of a colonoscopy is to detect signs of abnormal growths and other problems in the colon. But virtual colonoscopies only allow physicians to see polyps and other problems. The doctors can't actually do anything about them unless the person comes back for a traditional colonoscopy, Sullivan said. Only then can suspicious polyps be removed.
It would be extremely unusual to immediately perform a traditional colonoscopy -- complete with polyp removal -- after a virtual one, he said.
3. VIRTUAL COLONOSCOPIES MAY MISS PROBLEMS
The procedure may not detect the tiniest polyps, unlike traditional colonoscopies that are more sensitive, explained Dr. John Procaccino Jr., chief of colon and rectal surgery at North Shore University Hospital in Manhasset.
It's possible that a virtual colonoscopy may miss a polyp that would then have a chance to grow for another 10 years until it's noticed when the person has his or her next regularly scheduled colonoscopy, Procaccino said.
4. VIRTUAL COLONOSCOPIES DO HAVE POINTS IN THEIR FAVOR
For one thing, they have a lower risk for complications. Few people who have traditional colonoscopies -- one in several hundred -- suffer from perforations, but even that risk drops sharply for those who have the virtual procedure. "There's a smaller chance of a problem," Sullivan said. "It's not zero, but it's smaller."
And despite the cons of undergoing a virtual colonoscopy, Procaccino said that the procedure is appropriate for some people -- such as those who are on blood thinners and face an increased risk for bleeding during traditional colonoscopies. The virtual type also can be appropriate if a problem or condition prevents a person from having the traditional procedure, he said.
However, he noted that insurance companies might not pay for a virtual colonoscopy unless there's a good reason for it. "It's not an accepted standard as a screening tool," he said.
5. ANY KIND OF COLONOSCOPY IS BETTER THAN NONE
A colonoscopy is "not horrific," Procaccino said. The preparation is uncomfortable, he said, but "three hours of diarrhea can save your life."
Colon & rectal, thoracic and vascular surgeons
This is the 17th installment of a 26-week series in which Newsday presents Castle Connolly's list of top Long Island doctors.
COLON & RECTAL SURGERY
Dr. Marc Greenwald
310 E. Shore Rd.
516-482-8657
Dr. Arnold Leiboff
3400 Nesconset Hwy.
631-689-2600
Dr. Michael Moseson
60 Cuttermill Rd.
Great Neck
516-487-8738
Dr. John Procaccino Jr.
Div. of Colon & Rectal Surgery
900 Northern Blvd.
Great Neck
516-730-2100
Dr. William Smithy
222 Middle Country Rd.
631-638-2800
Dr. James Sullivan III
North Shore Oncology Assoc.
600 Northern Blvd.
Great Neck
516-487-9454
THORACIC SURGEONS
Dr. Shahriyour Andaz
444 Merrick Rd.
516-255-5010
Dr. Thomas Bilfinger
Stony Brook Univ. Med. Ctr.
Dept. Surgery, HSC Bldg.
Stony Brook
631-444-1820
Dr. Rick Esposito
North Shore Univ. Hospital
Dept. Cardiothoracic Surgery
300 Community Drive
516-562-4970
Dr. Harold Fernandez
Stony Brook University Medical Center, Cardiothoracic Surgery Division
Dr. Stewart Fox
444 Merrick Rd.
516-255-5010
Dr. Lawrence Glassman
225 Community Dr.
Great Neck
516-918-4388
Dr. Alan Hartman
North Shore Univ. Hosp.
Div. Cardiothoracic Surgery
300 Community Dr.
Manhasset
516-562-4970
Dr. Gary Kline
Summit Thoracic Institute
410 Lakeville Rd.
516-233-1952
Dr. Terry Palatt
15 Park Ave., Bay Shore
631-581-4400
Dr. Newell Robinson
100 Port Washington Blvd.
Vizza Bldg.
516-627-2173
Dr. Todd Rosengart
Stony Brook Univ. Med. Ctr.
Health Science Center
Cardiothoracic Surg., HSC-T19
Stony Brook
631-444-7875
Dr. Chanchal Saha
754 Old Country Rd.
516-931-0182
Dr. Scott Schubach
120 Mineola Blvd.
516-663-4400
Dr. James Taylor Jr.
Dr. Vadim Zeltsman
225 Community Dr.
Great Neck
516-918-4388
VASCULAR SURGEONS
Dr. Thomas Arnold
1110 Hallock Ave.
631-476-9100
Dr. Saqib Chaudhry
2001 Marcus Ave.
516-328-9800
Dr. Glenn Faust
2201 Hempstead Tpke.
516-572-4848
Dr. Robert Pollina
1110 Hallock Ave.
631-476-9100
Dr. William A Purtill
560 Northern Blvd.
Great Neck
516-466-0485
Dr. Apostolos Tassiopoulos
Stony Brook Univ. Med. Ctr.
HSC Bldg.
Stony Brook
631-444-4545
How they were picked
Castle Connolly Medical Ltd. is a health care research and information company founded in 1991 by a former medical college board chairman and president to help guide consumers to America's top doctors and hospitals. Castle Connolly's established survey and research process, under the direction of a doctor, involves tens of thousands of doctors and the medical leadership of leading hospitals.
Castle Connolly's team of researchers follows a rigorous screening process to select doctors on national and regional levels. Using mail and telephone surveys, and electronic ballots, they ask physicians and the leadership of top hospitals to identify exceptional doctors. Careful screening of doctors' educational and professional experience is essential to the committee. Not every good physician makes the list. Rather, the list is a way for patients to get started on their search for the best medical professional. Newsday is not part of the selection process.
Doctors do not and cannot pay to be selected and profiled as Castle Connolly Top Doctors.
To see the whole list . . .
Who else is on the list of Top Doctors? More than 6,000 listings are in the New York Metro Area edition of "Top Doctors," published by Castle Connolly Medical Ltd. The softcover list price is $34.95. For more information, go to castleconnolly.com, or call 800-399-DOCS.
