On March 7 at 7:30 a.m.,
Dr. Ramzi Alami
performed the first robotic surgery at
CalvertHealth Medical Center (CHMC)
– a gastric sleeve and hiatal repair for
a bariatric patient – culminating more
than a year of planning and preparation
and ushering in a new era of surgical
advancement.
On hand for the milestone moment was
Dr. Gregory
Dalencourt, who will direct the new robotic surgery program
at CHMC (see his bio at right) and CalvertHealth President
and CEO Jeremy Bradford who later said, “We are thrilled to
be able to offer our patients this leading-edge surgical option
to help them heal faster and get back to their lives sooner.”
According to CalvertHealth Surgical Services Director
Sherry Walker, MSN, RN, CNOR, CSSM, robotic-assisted
surgery offers several important benefits to patients including less pain, shorter hospital stays, quicker recovery,
smaller scars and improved patient satisfaction.
The addition of the $3.5-million da Vinci® robotic
assisted surgical (RAS) system, was a major part of
CalvertHealth’s “United We Thrive Campaign for
Cancer Care” to raise the funds needed to support
the critical and growing need for advanced cancer
care services conveniently and easily accessible
locally.
“The addition of robotic technology will allow us
to better treat urologic (prostate, kidney,), gynecologic
(uterine), thoracic (lung) and colorectal cancers right
here in our community,” said CalvertHealth urologist
Dr. John Cooper, who spearheaded the physician
effort along with Dr. Alami.
He went on to add, “Because robotic surgery
requires only a few tiny incisions and offers
greater vision, precision and control for the
surgeon, patients often recover sooner, move on
to additional treatments, if needed, and get back
to daily life quicker.”
Robotics Vital Part of Meeting Community Needs
The acquisition of the da Vinci® robotic assisted surgical
(RAS) system comes on the heels of a significant push by
CalvertHealth Medical Center to recruit surgical specialists
who bring an outstanding skill set to be able to apply the
new technology.
“This is an important investment that will upgrade our
surgical capability and capacity to deliver a superior surgical
experience for the patient,” said Dr. Alami. “Anything we can
do better and safer benefits the patient.”
He went on to add, “It will also enable us to expand our
services in certain fields and enhance our ability to recruit
new surgeons and retain experienced staff.
“Right now, we are focusing on bariatric surgery but we
can pretty much do any abdominal operation,” explained
Dr. Alami. “The urologists are going to have a huge use for
it. Without the robot, we would not be able to do prostate
cancer or prostate surgery in general. We would not be able
to do kidney tumors, which are very prevalent here.
“Eventually, we can do a lot with ventral or abdominal
hernias (refers to any protrusion of intestine or tissue
through a weakness or gap in the abdominal wall),” he
added. “That is a great application for the robot because we
cannot do a lot of these operations laparoscopically due to
the limitations. But we can do them robotically.”
According to Dr. Alami, who has 20 years experience
with robotic surgery, having this technology will make a
significant impact on the hospital’s ability to attract top
surgical talent. “Moving forward, we will need to recruit
more surgeons. Most general surgeons who are graduating
from residency programs today are being trained robotically
and at least laparoscopically.”
He went on to add, “You are not going to find someone
who wants to go to a place that does not have a robot. If we
want to continue growing in the trajectory we are going,
we must have the tools people are looking for to be able to
achieve that.”
Dr. Alami emphasized the
beneficial impact on retention, as well.
“Developing these surgical programs
has helped us retain some really good
talent in the OR, which is where you
want to have longevity. The ones who
are motivated are not going to stay if
they are not challenged.”
Intensive Training Key to Smooth Launch
“With the launch of the robotic
program, you can see the excitement
of the staff who are keen to get it
going,” said Dr. Alami. “They have gone
through the training program with a
lot of gusto. They approached it with so
much passion. So, it is no surprise that
we broke some records with our first
few cases.”
According to Dr. Alami, the robotics
team did a lot of legwork beforehand
from upgrading the facility, as needed,
to months of training. “We received
the robot in December knowing we
would not launch until about March.
We wanted to train our staff in our own
environment and on our own robot. By
training in our own setting, we were
able to deal with a lot of issues that you
face with the launch of a new program.”
He went on to add, “We also went
a step further and used virtual reality.
It was almost like having an actual
patient on the table. They also traveled
to other sites for case observation and
participated in hands-on training at
the Intuitive facility in Florida, which
developed the robotic system. They
really got the benefit of everything
the technology has to offer in terms of
training so they were completely ready
on day one.”
And the preparation paid off. On the
first few cases, an expert proctor, who is
an unbiased and independent observer,
came in to monitor and evaluate their
technical skills. According to Dr. Alami, they hit it out of the park. “When you
have the expert telling you: ‘You are
doing great. You guys have this down. You
are not going to have any problems. That
says it all.’”
Additionally, Dr. Alami said,
the technology provides feedback
that enables them to compare their
performance to surgeons all over the
country as well as the top 10 percentile.
“This feedback is valuable because it
helps you keep track of how you are
doing. One of those metrics is time…how
long did it take you to dock the robot,
how long did it take you to perform the
different steps of the surgery.”
He went on to add, “Looking at the graph for our first five gastric sleeve
surgeries, our average time was 49
minutes, compared to the nationwide
average for 1-10 cases, which was about
68 minutes and decreased to 47 minutes
after 100 cases.
“Our fifth case took 29 minutes…
when your fifth case puts you among
the top 10 percentile, it tells you we
have a good team that is doing an
unbelievable job and gives you the
confidence to say we are as good as any
other hospital let alone one our size.”
“Our staff went through the training with so much gusto. So, it is no surprise we
broke some records with our first few cases,” said Dr. Alami (pictured 4th from
right), who performed the first robotic surgery at CHMC.