Big step for a small hospital
OLIVIA - There was a point when Nathan Blad, CEO of the RC Hospitals and Clinics, might have seemed to be a prime candidate for nissen fundoplication, the surgery for acid reflux, or chronic heartburn.
But his heartburn was acute and due entirely to the hospital's surgeon. Dr. Jared Slater, M.D., had urged the small, rural hospital to invest well over $1 million to acquire a robotic surgery system.
"Spending, that kind of money, definitely gives you a little bit of heartburn, no doubt about it,'' said Blad, laughing.
One year after becoming the first critical care hospital in Minnesota to install such a system, Blad has no qualms (or heartburn) about the decision. "Great outcomes,'' said the hospital CEO.
Patient recovery times are much quicker when compared to laparoscopic or open surgical procedures. There is less trauma to the body, and patients experience less pain during recovery, said Dr. Slater. The need for pain medication following surgery has been reduced far more than he ever expected.
The small, rural hospital was the second in the country - by a day- to install the fourth generation robotic surgery system known as the Da Vinci X. Dr. Slater has now performed 100 procedures with it.
They include everything from gallbladder and appendix removals to bladder resections, colorectal cancer removal and yes, nissen fundoplication. He's also performed abdominal wall reconstructions for hernias, making him among only a handful of surgeons to perform the complex procedure with the system.
Dr. Slater demonstrated the system at an open house event on September 4. He called it the new standard for care. It's why he initially approached Blad about purchasing the system. "We should offer it because we know our patients will do better,'' he said.
It's minimally invasive. Only tiny incisions are required for surgery.
Still, patients were initially skeptical when the hospital began offering the option of robotic surgery, according to Dr. Slater. They wanted to know that a human was actually behind the controls.
Indeed, that is exactly the case. Better described as robotic-assisted surgery, Dr. Slater operates the four robotic arms as extensions of his own arms and wrists. The system gives him a three dimensional, clear view of the tissue he is repairing or incising, and allows for up to 40 power magnification. He literally can see and avoid blood vessels and nerves.
The Superman-like vision is also matched by a range of motion and dexterity no human body can offer. The computer-managed robot checks itself 1,700 times a second to assure there is no unwanted movement or tremor, according to Rick Brosseau, clinical sales representative for da Vinci.
Andrew Johnson, the RC Hospital surgery team's anesthesiologist, said it is obvious during surgery how the system reduces trauma to the patients. He sees much more consistency in the patient's vital signs he monitors.
Dr. Slater said it has allowed him to undertake more complex procedures without performing open surgery.
It's also less stressful on his body. Instead of standing like a hunchback over a surgical table and patient, he is seated and focused on the controls. He's completed intense, four-hour procedures and experienced no body fatigue whatsoever.
All prospective surgical patients are given the option of whether or not they want the robotic-assisted system. The initial skepticism has disappeared as patients hear from others about the benefits of the robotic system. They're not demanding but strongly requesting the robotic option, said Dr. Slater. To date, none have turned it down.
Because of the system, he's seeing more surgical patients, both local and from places ranging from Minneapolis to Iowa.
"It really gives Dr. Slater the tools he needs to be as successful as he can be,'' said Blad. He said the system has increased the types of surgeries that can be performed locally, and consequently, patients that may have been referred to other facilities are receiving care at home.
The heartburn-inducing investment is making economic sense one year later, according to Blad. It's helping build momentum and numbers for the hospital and its bottom line, he said.
Most important, it's living up to its promise of providing better care, said Blad. He believes it also serves as a great recruitment and retention tool for providers.
If he should ever need a surgical procedure that the robotic system can do, Blad said he would choose it and Dr. Slater without hesitation.