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Robotic Technology

Ushers in A New Era of Surgical Advancement at CHMC

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.
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