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Scripps Health Watch

Keeping the blood flowing: Q&A with Sunil Rayan, M.D.

As a vascular surgeon at Scripps Memorial Hospital Encinitas, Sunil Rayan, M.D., treats a wide range of conditions involving any blood vessel in the body that is not connected to the heart or brain. Dr. Rayan is also medical director of the operating room (OR).

The Encinitas resident shares his insights about his specialty and the hospital’s plan to expand.

What does a vascular surgeon do?

Our specialty is very broad. Most commonly, we care for people who have serious conditions such as aneurysms in the chest or abdomen, strokes, and peripheral arterial disease, which can cause muscle pain with exercise and limited mobility. We also do more elective procedures, such as treatment of varicose veins.

Do most patients require surgery?

About 80 percent of our procedures are catheter-based interventions, which require only a small incision to insert a catheter and perform angioplasty or stenting. Sometimes, we use catheter techniques to remove a vein. The rest require open surgery. Emergencies, such as bleeding from a ruptured aneurysm, or acute blockage of a blood vessel which causes an organ such as a kidney to start dying, require immediate surgery. Fortunately, we only see these about every 10 days or so.

How has vascular surgery changed?

We can do much more through very small incisions, with less pain and bleeding and much faster recovery. Twenty years ago we’d do an aneurysm repair by making a major incision from the sternum to the pelvic bones. Patients would be in the ICU for three days, in the hospital for a week and recovering for a month. Ten years ago we replaced that with stenting, which required two small groin incisions, a couple days in the hospital and a few weeks of recovery. Now, we can do some procedures via a needle puncture in the skin with no incision. People leave the hospital in a day, and recovery is a few days.

As medical director of the OR, what is your role?

We have four operating rooms right now and all of them run from morning to evening, so I make sure we have good feedback from the surgeons to improve efficiency and satisfaction. Communication between physicians, staff and administration is critical to keep everything running like a well-oiled machine. Scripps Encinitas is one of the state’s top hospitals for OR efficiency.

Any plans to expand?

We’re planning to add two more ORs by 2015. A new building is already under construction, and the plan is to move the existing ER and ICU into it in 2015. The old facilities will be renovated to include the new ORs and other services.

How long have you lived in Encinitas?

We’ve lived in North County for eight years, and bought our house in Encinitas three years ago. We love it here and plan to live here forever.

How do you like to spend your free time?

We have 8-month-old twins, so that’s 99 percent of my free time. We also have a five-year-old. Between my family and my medical practice, that’s more than 100 percent.

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