Nyack Hospital - Highland Surgical Associates Partnership Provides Comprehensive Surgical Care

By Jennifer Webster
Wednesday, July 30, 2014
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For the past four years, Highland Surgical has worked with Nyack Hospital to offer round-the-clock emergency coverage and standard-of-care elective surgeries.

Highland Surgical Staff members Helen Panaro, left, and Pat Swanson, right, review patient information with surgeon Lawrence F. Simon, MD, FACS.

Lawrence F. Simon, MD, FACS, Director of the Department of Surgery at Nyack Hospital and Clinical Associate Professor at Touro College of Osteopathic Medicine, had been practicing in Rockland County for many decades in partnership with Max Rast, MD, when he decided to strengthen his affiliation with Nyack Hospital.

“Dr. Rast retired in the mid-1980s,” Dr. Simon says. “After that, I put all my efforts into the hospital where I had been practicing for my entire career.”

Five years ago, Dr. Simon realized the hospital needed a dedicated practice of employed surgeons. Working with Wagdi F. Ibrahim, MD, Dr. Simon formed Highland Surgical Associates to meet that need. Lee S. Fleischer, MD, CM, FACS, general and laparoscopic surgeon and Assistant Director of the Department of Surgery at Nyack Hospital, and Aleksandr Rakhlin, MD, FACS, general and laparoscopic surgeon and Medical Director of Nyack Hospital’s Trauma Program, soon joined the practice. In 2011, Highland Surgical Associates moved into its present offices at One Crosfield Ave.

“After Dr. Ibrahim passed away, Adrienne Fueg, MD, FACS, joined us,” Dr. Simon says. “We are now a four-person surgical group exclusively devoted to Nyack Hospital.”

“As surgeons retired, the hospital needed to know it had a strong surgical department,” Dr. Simon says. “Coming under the auspices of the hospital created a win-win situation. Nyack Hospital depends on our skills, while we rely on the hospital to take care of our business needs and build up our programs.”

While Highland Surgical Associates has been together only a short time, Dr. Simon says, it is made up of experienced surgeons, many with long histories in the community.

Dr. Simon obtained his medical degree at the State University of New York Upstate Medical Center, followed by a residency at St. Luke’s Hospital in New York City. After two years as a major in the Air Force, he came to Nyack. He has served as president of the Rockland County branch of the American Cancer Society and on the Executive Board of the Rockland County Medical Society.

Dr. Simon is a fellow of the American College of Surgeons and a member of the American Society of Breast Surgeons. He is board-certified by the American Board of Surgery and has been listed as a “Top Doctor” of the New York metro area for several consecutive years.

“With the addition of each physician, we bring in new areas of expertise,” he notes. “We are all well-trained in general, laparoscopic and breast surgery. We have recently added advanced minimally invasive procedures.”

Dr. Fleischer, like Dr. Simon, says changes in the healthcare industry have favored hospital-affiliated practices such as Highland Surgical.

Dr. Fleischer obtained his medical degree at McGill University and completed his residency at Beth Israel Medical Center in New York City. Dr. Fleischer joined Nyack Hospital in 1996 and was previously affiliated with Good Samaritan Hospital.

Dr. Fleischer has been recognized as a “Top Doctor” of the New York metro area consistently since 2005, as well as being named a “Top Doctor” of the Hudson Valley for the past seven years. He is committed to serving the medical community; in addition to his present appointment as Assistant Director of Nyack Hospital’s Department of Surgery, he serves on the Peer Review and CME committees and is Chair of the Operating Room Committee. Dr. Fleischer is a member of the New York State Medical Society, the Rockland County Medical Society and the American Society for Breast Surgeons.

Dr. Fleischer is a diplomate of the American Board of Surgery and a Fellow of the American College of Surgeons.

“I came to the county in 1992 and met Dr. Simon at that time, though I wasn’t working with him,” he recalls. “Then, when health care began changing, Nyack Hospital contacted me about associating with them. Dr. Rakhlin and I negotiated with Nyack Hospital to join Dr. Simon and Dr. Ibrahim at Highland Surgical under the umbrella of Highland Medical Group. We continue to offer the same services we always have, and are expanding on them as well.”

“Highland Surgical Associates is readily available and can handle all general surgical needs in the county without patients needing to travel out of the area. As attending physicians, we give patients more attention than they might receive from fellows or residents. We are experienced surgeons with excellent backgrounds in all areas of general surgical care.”
— Lee S. Fleischer, MD, CM, FACS, Assistant Director of the Department of Surgery at Nyack Hospital

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Dr. Fleischer has been recognized as a “Top Doctor” of the New York metro area consistently since 2005, as well as being named a “Top Doctor” of the Hudson Valley for the past seven years.

Affiliation with a hospital, Dr. Fleischer says, has advantages.

“We do everything as we did before, except that we are not responsible for the administrative duties of the practice,” he says. “This allows us to dedicate more time to patient care.

“I am proud of how we have established an excellent surgical group, whose members collaborate very well, to offer broad-based general surgery and care for the patients in our community.”

Unlike Drs. Simon and Fleischer, Dr. Rakhlin has been associated with Nyack Hospital for almost all his career.

“I lived in Nyack while I was completing my residency and fellowship. Then when it came time to establish a practice, I became affiliated with Nyack Hospital and couldn’t imagine myself moving.”

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A general and laparoscopic surgeon, Dr. Rakhlin directs the Trauma Program at Nyack Hospital.

A general and laparoscopic surgeon, Dr. Rakhlin directs the Trauma Program at Nyack Hospital. Dr. Rakhlin obtained his medical degree at the University of Buffalo School of Medicine and, in addition to his residency in general surgery, completed a fellowship in laparoscopic surgery at New York Medical College. Dr. Rakhlin has presented research on single-incision laparoscopic surgery at the Clinical Congress of the American College of Surgeons and the Society for Critical Care Medicine. He has also published research in trauma medicine, gastric bypass surgery and hernia repair. Dr. Rakhlin is a fellow of the American College of Surgeons and board-certified by the American Board of Surgery.

“In today’s practice of medicine, patients are so complicated that care coordination is a necessity,” Dr. Rakhlin observes. “The physicians of Highland Surgical Associates work closely with primary care providers to optimize patients before surgery and to follow up afterward. We collaborate with colleagues in multiple disciplines. In the case of a cancer patient, for instance, it may take only 15 minutes between the time a patient sees an oncologist and when he or she is seen by the surgeon to be evaluated for a curative or palliative procedure.”

Laparoscopic and Minimally Invasive Surgery for Improved Outcomes

Surgeons at Highland Surgical perform many procedures in a minimally invasive fashion. Hernia repair, gallbladder surgery and colectomies are just a few of the procedures performed laparoscopically.

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Highland Surgical Associates physicians perform a laparoscopic colon procedure at Nyack Hospital.

“I have performed laparoscopic surgery since 1990,” Dr. Fleischer says. “As we have become more experienced, we can now operate in a minimally invasive fashion on those patients who would previously had contraindications for laparoscopic surgery. For instance, gallbladders can be removed laparoscopically on almost any patient today. Similarly, we repair primary or recurrent hernias laparoscopically, resulting in faster recuperation for patients.”

Physicians from Highland Surgical have teaching experience, as well. Dr. Fleischer has spent much time in New York City training surgeons on laparoscopic procedures.

According to Dr. Rakhlin, the physicians perform a wider range of laparoscopic surgeries every year. Patients need not request a laparoscopic procedure for a physician to offer one; however, many are quite relieved to learn they will be able to leave the hospital and return to their former activity levels quite rapidly.

“I perform minimally invasive laparoscopic colon surgery,” Dr. Rakhlin says. “Even seven years ago, this procedure was typically performed as an open surgery.”

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Aleksandr Rakhlin, MD, FACS, general and laparoscopic surgeon and Medical Director of Nyack Hospital’s Trauma Program (center), and Lawrence F. Simon, MD, FACS, Director of the Department of Surgery at Nyack Hospital and Clinical Associate Professor at Touro College of Osteopathic Medicine (right), mobilize the colon while Lee S. Fleischer, MD, CM, FACS, general and laparoscopic surgeon and Assistant Director of the Department of Surgery at Nyack Hospital (left), monitors the procedure screen.

The minimally invasive approach has numerous advantages, including reduced blood loss and faster recovery, while still achieving the same oncologic outcomes.

Dr. Rakhlin is also pleased with the robust results of minimally invasive hernia repair.

“One patient was a karate champion who needed to recover quickly for a competition,” he says. “I told him there was a possibility he might not be able to fight, but he was able to compete soon after surgery.”

Care for Chronic Wounds

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Dr. Fueg provides surgical coverage at the Wound Care Center at Nyack Hospital, where people with nonhealing wounds can find expert care in a friendly setting.

At the Wound Care Center at Nyack Hospital, people with nonhealing wounds can find expert care in a friendly setting. Two members of Highland Surgical Associates, Dr. Simon and Dr. Fueg, provide surgical coverage for the Wound Care Center.

“We are a well-established program, caring for chronic, debilitating wounds resulting from diabetes, vascular conditions, pressure ulcers and other causes,” Dr. Simon says.

The Wound Care Center is in the process of bringing a hyperbaric unit to Nyack Hospital, he adds. Affiliated with Healogics, the Wound Care Center has a healing rate of 94 percent after approximately one month of treatment.

Emergency Medicine Brings the Community Together

All certified in trauma medicine, the physicians of Highland Surgical Associates cover the Emergency Department trauma service at Nyack Hospital. Patients know that whenever they come to the hospital, day or night, they will be cared for by expert, board-certified surgeons, Dr. Simon says.

“We are the backbone of the hospital,” he says. “We treat any patient who comes to us in need. We provide for Emergency Department coverage and the necessary backup for other medical services when they require a surgeon’s assistance.”

Trauma medicine in Rockland County has several distinguishing features.

“This is a big area for bicyclists in the summer,” Dr. Rakhlin says. “Injured cyclists are challenging to treat because they may move as fast as motorcyclists do, while wearing less personal protective gear. One cannot overstress the importance of helmets, for example, in avoiding devastating brain injuries.”

Elderly people suffering trauma also frequent the Emergency Department at Nyack Hospital, Dr. Rakhlin says.

“We see an increasing caseload of geriatric trauma,” he says. “As the population ages, more patients are on blood thinners or have irregular heart beats, blood clots and arterial narrowing. Any of these conditions could make patients prone to falls. Many of these patients are older people who continue to be very active, climbing roofs to prune branches, for example. The resulting accidents can be challenging to treat. With our multidisciplinary, integrated program of surgeons, primary care physicians and hospital intensivists, we are well-equipped to deal with these complex cases.”

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Highland Surgical Staff (l-r): Helen Panaro, Pat Swanson, Sherry Schnoor, Nicole Correa, Candice Phillips, Jackie Sanchez and Marla Fleischer

Working in the Emergency Department helps these physicians keep in touch with the community. Whenever patients need surgery, whether elective procedures or for a traumatic event, chances are they will see a familiar face.

“I have practiced medicine in Rockland County for so long I am now seeing the third generation of patients,” Dr. Simon says. “I can’t go anywhere without being greeted by someone I have operated on or whose family member I have operated on. Our community knows and trusts us. That is the beauty of what we do.”


To learn more, visit www.highlandmedicalpc.com and select “Surgery.”