PI3: Program for Intelligent Image-Guided Interventions

�鶹��: Interventional Radiology, Colon and Rectal Surgery

Upper East Side
1283 York Avenue
New York, NY 10065

Call

(646) 962-2693

Upper East Side
1315 York Avenue, 2nd Floor
New York, NY 10021

Call

(646) 962-5757

At �鶹��, the Program for Intelligent Image-Guided Interventions (PI³) is molding the future of diagnosing and treating complex conditions by bringing together a team of experts in multiple specialties. Under the leadership of Drs. Jeffrey Milsom, Bradley Pua and Art Sedrakyan, PI³ sees and treats your complex conditions using 21st-century technology combined with a caring, respectful healthcare team.

Our Approach

Modern surgical techniques allow surgeons to operate through small incisions. Still, we have taken it one step further by integrating 3D models of your anatomy to deliver a more tailored and precise plan for your needs, often avoiding surgery altogether. Our team is among the leaders in developing this for clinical use. This model helps surgeons and interventional radiologists plan and execute complex procedures with greater precision. Our advanced imaging technology allows us to see and diagnose diseases at earlier stages and apply the latest and most modern therapies.

Treatment Tailored to You

Before developing your treatment plan, we approach your diagnosis through the efforts of a multidisciplinary team. One unique aspect of this method is that your diagnostic journey involves one or more imaging exams, such as CT or MRI, that are processed into a 3D model.

Your care team can see the exact structure of the treated area, including blood vessels, tissues and organs. When appropriate, the team can place these images directly over the patient during procedures using augmented reality (AR), leading to a safer outcome and quicker recovery. Thanks to this focused strategy, our team can offer new treatment techniques available in very few medical centers around the country.

Your Team of Experts

The multidisciplinary team at PI³ is on a mission to revolutionize medicine through forward-thinking and advanced technologies. Members of the team include:

Conditions We Treat Using Our Methods

At PI³, we use novel image-guided approaches to treat several health conditions, including:

Tumors (cancers and precancerous growths). Tumors within the body cavities (chest, abdomen and pelvis) are nearly always diagnosed and treated in concert with imaging tests, such as CT scans, ultrasound and MRI, and placing scopes inside the body. Diagnosis usually requires a biopsy, where a PI³ provider removes a small sample of cells for analysis using image guidance. While it is often difficult to locate suspicious areas when using conventional methods, our experts use image-guided approaches to locate these areas and retrieve tissue samples for laboratory evaluation, perform excisional biopsies or ablation to remove or destroy abnormal masses or promote further treatment planning.
Small and large bowel obstruction. Blockages in the small and large intestines can prevent food from passing properly, causing severe pain, bloating, vomiting and constipation. These blockages often result from adhesions, hernias, strictures or tumors. At PI³, our experts use a novel combination of endoscopic and interventional approaches to relieve obstructions. Using tiny cameras placed inside the GI tract, the provider reaches the blockage and expands a small balloon to widen the narrowed area.
Abscesses. An abscess is a collection of pus that forms due to infection, commonly occurring in the abdomen or around the intestines. Symptoms may include fever, pain and swelling. Our team can drain abscesses using image-guided procedures, such as percutaneous drainage, which places a small tube to remove infection and promote healing. In more complex cases, we may combine interventional techniques with novel surgical methods to ensure complete resolution and prevent recurrence.
Stoma creation and management. Some patients require a stoma—an opening in the abdomen that allows waste to exit the body—due to an underlying serious intestinal disease such as cancer or infection, or injury. Stomas may be temporary or permanent. At PI³, we specialize in optimizing stoma function and addressing complications such as retractions, strictures and skin irritation. Our team provides personalized guidance on stoma care to enhance quality of life and prevent complications.
Hybrid procedures. PI³ bridges the gap between interventional radiology and surgery, offering innovative hybrid procedures that reduce the need for major operations collaborating with other specialties, such as gastroenterology and gynecologic oncology. These latest techniques allow for precise, minimally invasive treatment of complex GI conditions, improving recovery times and reducing hospital stays.

Enhancing Future Care With Data-Driven Insights

PI³ team members carefully collect patient data and enter it into a unique program called ImagineHIVE (High-performance Integrated Virtual Environment). Using this program permits analysis of images, application of AI to our procedural data and creation of 3D models, all leading to optimal outcomes for our patients.

Using ImagineHIVE, our PI³ team learns to perform various tasks that improve our efficiency.

Currently, ImagineHIVE helps us:

Develop new ways to use endoscopes and other tools
Facilitate clinical research studies
Modify treatment plans to best meet an individual patient’s needs
Predict medical trends and issues with greater confidence

Patient Resources

What to Expect

Before Your Procedure

You’ll receive specific instructions on how to prepare for your procedure, including any dietary changes and medication adjustments. As part of your pre-operative consultation, the team will review your condition and the planned approach, including how 3D imaging and other technologies will guide your treatment.

During Your Procedure

Your procedure will be performed by a team of specialists from both interventional radiology and surgery, ensuring a coordinated and efficient approach. Your care team will use advanced imaging techniques to guide the procedure, ensuring precision and reducing the risk of complications.

After Your Procedure

You’ll receive detailed instructions on post-procedure care, including how to manage any drains or incisions and what signs of complications to watch for. Our team will schedule follow-up appointments to monitor your recovery and address any questions or concerns.

Our Doctors

FAQ

How does 3D modeling benefit you?

Enhanced precision: The 3D model provides a clear and accurate view of your anatomy, helping your doctors plan the surgery down to the smallest detail. This leads to more precise procedures, improving outcomes and reducing the risk of complications.
Customized care: Every patient’s anatomy is unique. By using a 3D model, your doctors can tailor the procedure to your specific needs, ensuring that they address your condition most effectively.
Better communication: The 3D model allows your care team to visualize and discuss the surgical plan in detail. It also helps explain the procedure to you so you can better understand what will happen during your surgery.

How is a 3D model created?

Imaging scans: The process begins with detailed imaging, usually a CT or MRI scan. These scans capture high-resolution images of the area that will be treated.
Model creation: The images from the scan are then processed using specialized software to create a 3D model. This model can show the structures from multiple angles and highlight key areas that need attention during the procedure.
Surgical planning: Your doctors use the 3D model to plan the surgery. They can simulate the procedure, decide on the best approach and even predict potential challenges. This step is crucial for complex surgeries, where precision is vital.
Review and refinement: Before the surgery, your care team will review the 3D model together, often during pre-operative meetings. They may adjust their plan based on the model, ensuring they are fully prepared for the surgery.

What can I expect if 3D modeling is used for surgery?

Surgical preparation: The 3D model will be referenced during your surgery, helping your doctors navigate your anatomy more accurately. This can be especially important in hybrid procedures involving interventional radiology and colorectal surgery.
During the surgery: We now have the capability of uploading the 3D image onto Augmented Reality goggles (Microsoft HoloLens 2) and using it to accurately depict the anatomy.
Post-operative review: After the surgery, your doctors may use the 3D model to explain what was done during the procedure and to show you how your condition was treated.

Why is 3D modeling important in PI3?

In PI³, 3D modeling is a valuable tool for navigating complex procedures between interventional radiology and surgery. It helps coordinate the efforts of both specialties, ensuring that the procedure is as safe and effective as possible. By using 3D modeling, our team can provide you with the highest level of personalized care, aiming for the best possible outcomes.
If your surgery involves 3D modeling, our team will guide you through each step, ensuring you understand how this technology is being used to enhance your treatment. Your health and safety are our top priorities, and we’re here to provide you with the most advanced care available.

Do I need a referral?

This depends on your insurance. Please contact your insurance provider directly for more information.

Do you accept insurance?

Yes, we accept several types of insurance. Contact our team at (646) 962-5757 for more information.

How long is the initial visit?

The first appointment will be 30 minutes.

What should I wear to my appointment?

Please come dressed in comfortable clothing and shoes that are easy to remove.

How do I prepare for my first visit?

You should fast for four hours. You can still take your daily medication with water.

How are appointments conducted?

Appointments can be booked in person or virtually.

How long will I continue to follow with the program?

The frequency of visits and follow-up with the program will depend on your health history and tailored care plan.

What should I bring to my first appointment?

Here are some items to bring to your appointment:

Copies of your medical history, related imaging reports, and/or lab reports if you have them
List of any medications that you may be taking and their dosages
Your insurance information and card(s) (i.e., HMO, Medicare, Medicaid)
A list of any questions you may have for your doctor

If you are insured under a managed care plan, before your appointment:

Confirm that the physician you will be seeing is a participating provider in your plan, and obtain any prior authorization, if required.
Confirm that any service you will receive is covered under your plan, and obtain any prior authorization, if required.
Obtain any necessary referral authorization from your primary care physician before seeing a specialist.
Be prepared to pay your co-payment at the time of service.

If you do not have insurance or the doctor you are seeing does not participate in your insurance plan, please be prepared to pay at the time of service.

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