Article used with permission from The News & Sentinel
A partnership between WVU Medicine Camden Clark and PARS Brain and Spine Institute has brought robot-assisted surgery to the region with new equipment that will help create better outcomes for patients.
The two organizations have come together to bring a Globus Excelsius Robot to the local medical center. It is a minimally invasive spine operating robot, the first of its kind in West Virginia. The unit has been in use since Nov. 20.
“It is exclusively at our hospital,” said Camden Clark Vice President of Physician Enterprises and Clinical Integration Sean Smith. “We did an operating lease with PARS to bring this here.
“Surgeons will be using this here at Camden Clark.”
Smith said when Camden Clark looked at its mission and vision for the hospital, officials want to make it the leading regional comprehensive medical center known for high quality, cost effective, state-of-the-art care.
The new Globus Excelsius Robot used at the WVU Medicine Camden Clark Medical Center allows surgeons to pinpoint where they will place screws, plates and other hardware using continuous pictures of the patient which creates a 3-D picture of the patient in real time. (Photo Provided)
“This really helps us advance that mission in becoming much more technologically advanced,” Smith said. “This is really helps us advance that mission and becoming much more technically advanced with the first minimally invasive robot we have had at Camden Clark. It will be the first entry way into that service line.
“Again, this is the first robot of its kind in West Virginia. We are very proud to be the leader in minimally invasive spine surgery. It will help us to advance to be able to do it here in this state.”
Less than 100 of these robots are in clinical facilities in the United States, said Adam Farnsworth, COO at PARS.
“That means we are on the forefront of adopting new technology and bringing it into our community,” he said.
The robotic unit allows surgeons to pinpoint where they will place screws, plates and other hardware using continuous pictures of the patient which creates a 3-D picture of the patient in real time.
“This technology is the first of its kind to combine navigation and a robotic arm,” Farnsworth said. “Navigation is the ability to allow the surgeons to see what they are doing more effectively in the procedure.
“The robotic arm will create algorithms from that and give the surgeon the exact trajectory to place their equipment, their screws, into the patient.”
If the patient involuntarily moves, the system stops and readjusts and gives the exact trajectory again, Farnsworth said, adding it can reposition itself and has all of the necessary fail-safes in place to make sure that trajectory is correct.
“What the robotics piece does is it allows the surgeons to have a higher percentage rate in properly placing instrumentation, screws and rods for fusion,” he said. “The minimally invasive part of the procedure allows you to work with smaller incisions and hopefully reduce the surgical time.
“The goal is to reduce re-admissions and have better outcomes.”
Drs. Rammy Gold and Houman “H.K.” Khosrovi of PARS are the two doctors trained in how to use the equipment. PARS is working to bring in another surgeon who will be able to use the equipment by early next year.
The surgeons and operating room staff completed extensive training in how to use the equipment, Farnsworth said, adding the surgeons went and trained at the headquarters of the facility where it is produced.
Khosrovi said the unit is the most updated technology in helping spine surgeons perform spine surgery and placing instrumentation.
“This does it in the most accurate way with less risk to the patient compared to the conventional ways we were using,” he said. “It is very innovative. It lowers the stress in the OR for everyone.
“It adds accuracy to the patient’s care. It is one really good step in the progress of spine surgery technology. I think this is just the beginning of more innovation to come in all surgical fields, especially spine surgery.”
Gold agreed, saying the unit has increased the success from 95 to 99 percent with everything from the simple kinds of fusions they do. With the very difficult fusions, the people with Scoliosis and unusual bone quality, it takes what would be an 85 percent success rate and makes it a 99 percent success rate, he said.
“Especially with the really difficult cases it makes a huge difference in patient outcomes,” Gold said. “I think with those really difficult cases, it will make surgeries go more quickly which is in the best interest of the patient.”
The importance of having good trajectory is the equipment won’t slip or move out of place if it is gotten exactly right.
In using the unit, Gold is very impressed with its accuracy.
“I am able to do things now that I wasn’t able to do without the robot,” Gold said. “For instance, when we have to remove a screw and replace it, we like to get a new trajectory for the new screw so it goes through normal bone.
“With relatively small spines we are operating on that can be difficult and the robot makes it very easy.”
Candace White, director of OR Operations at Camden Clark, spent around 10 months working with the doctors, OR personnel and researching a number of different systems that were available to find the one that would work best for the surgeons and meets the needs of the patients.
“This is going to take many procedures and make them minimally invasive,” she said.
This program afforded them an opportunity with the different things it could do, encapsulated into one program that met many of the needs they wanted it to.
“When you keep the patient’s best interest at heart that makes it all come together,” White said. “I think it is great everyone and be able to offer these services.”
Many back and neck procedures have had lengthy recovery times, White said. The unit will enable a quicker recovery time for them, he said.
“This will enable a quicker recovery time for them,” she said. “Smaller incisions and quicker recovery time which is important to most people when dealing with surgeries.
“People can get back to doing the things they are used to doing around the home or getting back to work. As technology evolves and new things come out, I think it is going to be awesome that we will be able to offer this to this community and patients in the Mid-Ohio Valley.”
The unit represents “a significant investment” the groups are making in the community Farnsworth said. Officials declined to discuss the exact cost of the unit.
“It is a significant investment financially,” Smith said. “It aligns our values and what each entity is trying to accomplish with PARS, Camden Clark and WVU Medicine.
“Each year when we look at our strategic plan everything we do relates back to our core mission which is to take care of the healthcare needs of our community. To do that, we have to be able to provide high quality care.”
Officials said the unit can help reduce costs by eliminating the need for a number of redundant services, eliminating complications that could result from care given and more. The unit is also mobile and can be moved from one operating room to another rather than having one unit stationary in one operating room and having to schedule patients accordingly.
“It brings our partnership closer together because our values are aligned,” Smith said. “It provides better continuity of care and we can better manage the patient population when we do it together as opposed to separately.”
“Our patients and community should know that we are heavily invested in providing state-of-the-art care,” he said. “I think our partnership between PARS and WVU Medicine is especially unique to where a private and a public not-for-profit institution can come together for what is in the best interest of the community and our patients.
“We don’t want our patients to have to travel outside of this area. We want to bring the best of the technological world here, locally, close to home so they have those services.”
Farnsworth believes robotic units like this one will be the standard of care in the next 7-10 years everywhere in the United States. They wanted to bring it to this area first.
It is the first of its kind in West Virginia and the only one officials knew of in Ohio was in Columbus.
Officials didn’t want patients to have to travel three hours or so to have these kinds of spinal surgeries performed as well as travel that amount of time for follow-up appointments as they recovered. Having it available locally works best for the patients, they said.
As things change, the technology of the system can also be improved.
“This is something that can also grow,” Farnsworth said. “The technology serves as a hub and spoke model for future enhancement.”
Within a couple of years the unit will be able to be used in cranial work with a minimal investment to bring it up to that point, because the software and the robotic equipment already exist and it is a matter of changing out a couple of parts.
“With its ability to grow with us over time, in terms of adding new procedures with it, we thought it would be the best fit,” Farnsworth said. “If we bring the best investments and the best technology here, we are eliminating a big hassle from our patients in having to leave this area.
“That is what we wanted to do when we teamed together to work on this investment and insure that the best of the best is available here.”