May-June 2016 | THE EXPERIENCE OF A SURGEON, THE ACCURACY OF A ROBOT

THE CUTTING EDGE: Dr. James C. Todd III, head of Structural Heart Disease at the Guerrieri Heart & Vascular Institute, helped bring TAVR to PRMC.
 THE EXPERIENCE OF A SURGEON, THE ACCURACY OF A ROBOT THE EXPERIENCE OF A SURGEON, THE ACCURACY OF A ROBOTI, ROBOT: Dr. Kurt Wehberg, PRMC’s Chief of Cardiothoracic Surgery, using the hospital's state-of-the-art robotic-surgery technology.THE A-TEAM: The elite surgeons of PRMC's heart, lung surgery program.

MEDICAL PROFILES

THE EXPERIENCE OF A SURGEON, THE ACCURACY OF A ROBOT

Peninsula Regional Medical Center’s heart, lung surgery program ranked among top in U.S.

Peninsula Regional Medical Center has something to celebrate. In three short years, its robotic heart-and-lung surgery program has performed more than 300 procedures and boasts one of the highest success rates in the country. Data from Intuitive Surgical — the company that manufactures robotic surgical systems — ranks PRMC’s robotic cardiothoracic surgery program No. 6 on the East Coast in terms of volume and even higher in terms of outcomes.

In 2014, the Society of Thoracic Surgery National Database estimated 395,000 open heart surgeries and 107,000 thoracic chest surgeries were performed in the United States, the majority of which were done using the “old-fashioned open technique.”

About five years ago, PRMC’s Executive Vice President and Chief Operating Officer Cindy Lunsford approached the local cardiothoracic surgeons to discuss the possibility of starting a robotic program at PRMC. The goal was to offer a less invasive surgical option to aid in quicker patient recoveries.

Training was the first step to making the program a reality. After completing a series of courses, the team — Kurt Wehberg, MD; Ty Huskey, PA-C; and Joe Walters, PA-C — traveled to Alabama in 2011 to spend a week with Dr. Robert Cerfolio, the world’s most preeminent robotic surgeon. “Cerf,” as his colleagues know him, immediately recognized the amazing skills possessed by the PRMC team.

“Wow, these Salisbury guys are phenomenal,” he said. “They’re going to develop a great robotic program.

Performing more than 750 major operations each year, PRMC now boasts one of the Top 10 busiest robotic cardiothoracic surgery programs in the country, with one of the most successful safety records. Of those procedures, a large percentage is performed using robotic techniques; in fact, the majority of lung, pericardial, mediastinal and other thoracic cavity procedures are performed using the robot. PRMC surgeons also perform single-vessel coronary artery bypass grafting using robotic assistance.

Careful analysis shows patients are recovering in a way healthcare has never seen before. After a typical robotic thoracic surgery operation, the patient wakes up from anesthesia without a breathing tube, without an epidural catheter, and without a foley catheter. Patients are not complaining of a lot of pain, and are not requiring high doses of complicating pain medications. They are walking down the hallway on the second post-operative day, joking with staff and requesting to go home.

Instead of a typical hospital stay of seven days, patients are being discharged in two or three days. Patients with emphysema undergoing a lung operation are no longer gasping for breath. Their respiratory muscles aren’t split open like the “open technique” because the pencil-sized robotic instruments barely affect their breathing muscles. Finally, patients — even high-risk patients — are not having as many complications when the robot is used.

“It’s amazing that our thoracic surgery program at PRMC has literally transformed itself into a robotic program in just three years,” said Kurt Wehberg, MD, PRMC’s Chief of Cardiothoracic Surgery. “Every single member of our team has performed at a superior level, and the end result is a world-class program. The patients of our community are so fortunate and blessed to have a program with such successful outcomes.”

 

ON THE CUTTING EDGE

Surgeons at Peninsula Regional CV Surgical pride themselves on their ability to perform cutting-edge procedures using state-of-the-art technology. World-renowned for their innovative research, they have conducted numerous studies and published peer-reviewed, professional articles on their findings. Here are some of the revolutionary heart procedures they offer:

Transmyocardial Revascularization (TMR):
CV surgeons are using heart lasers to improve blood flow to the heart when stents and surgeries are no longer effective. During TMR, as many as 40 to 50 micro laser channels are used to drill into the heart muscle to stimulate the growth of new collateral arteries, called angiogenesis.

TMR + Injection of Healing Factors (PRP):
CV surgeons published a ground-breaking article using a combination of TMR heart laser and the injection of a patient’s own healing factors in the form of STEM cells and platelet-rich plasma. This study showed dramatic improvement in chest pain and significant improvement in heart function.

TMR + Cardio-omentopexy: CV surgeons are currently evaluating the role of TMR heart laser and wrapping the heart with the patient’s own omentum. The cardio-omentopexy procedure is thought to act as a continuous source of extra blood supply and STEM cell healing factors to improve angina in patients with end-staged coronary artery blockages.

Endovascular Aneurysm Repair (EVAR):
This minimally invasive procedure is used to treat abdominal aortic aneurysms. The procedure involves the placement of an expandable stent graft within the aorta to treat aortic disease without operating directly on the aorta. Dr. Nicholas Ogburn, head of the Central Thoracic Aortic Disease Program, introduced minimally invasive aneurysm repair almost 20 years ago. Now, teamed up with Chief Vascular Surgeon Dr. Douglas Wilhite, PRMC is pioneering endovascular approaches to aneurysm repairs.

Robotic Coronary Artery Bypass Grafting (CABG): During CABG, a healthy artery or vein from the body is connected to a blocked coronary artery. That grafted artery bypasses the blocked artery, creating a new path for blood to flow to the heart. Robotic-assisted CABG has been successfully performed in a select group of patients who require only a single or double bypass on the front of the heart.

 

Jeanne Ruff, executive director of PRMC’s Guerrieri Heart & Vascular Institute, said Delmarva residents are fortunate to have such experienced surgeons so close to home.

“New cardiac surgeons coming out of training are usually very specialized in heart surgery,” she said. “We’re fortunate to have talented surgeons here at PRMC who can perform not only heart procedures, but vascular and thoracic procedures, as well.”

 

New TAVR procedure treats high-risk patients with valve blockage

At Peninsula Regional Medical Center, a new, minimally invasive procedure has been pioneered to help patients who suffer from heart disease.

Transcatheter Aortic Valve Replacement, also known as TAVR, is now being used to treat aortic stenosis, a disease in which calcium builds up in the heart’s aortic valve until the valve does not open properly. The traditional treatment is a valve replacement achieved by open heart surgery, but for some that procedure is too risky. That’s where TAVR comes in.

“With TAVR, an artificial valve is loaded in a narrow tube called a catheter, which is usually inserted in an artery in the groin, much like a heart catheterization, and guided through the circulatory system to the calcified valve,” explained Steven Hearne, MD, Medical Director of PRMC’s Guerrieri Heart & Vascular Institute. “The new valve is deployed from the catheter inside the diseased valve where it takes its place and restores normal valve function and allows for normal circulation.”

Dr. James C. Todd III, head of Structural Heart Disease at the Guerrieri Heart & Vascular Institute, helped bring TAVR to PRMC. He completed specialized training at Prince Charles Hospital in Brisbane, Australia, with Sir Mark F. O’Brien, one of the world’s most preeminent valve surgeons.  After training, he brought an entire spectrum of complex valve operations to Salisbury, Md., and has treated thousands of patients on Delmarva.

PRMC is the first hospital on the Eastern Shore to offer TAVR. Since the first procedure was performed in June 2015, the PRMC team has grown to include Hearne, Dr. Nicholas Ogburn, Dr. Kurt Wehberg and Steve Wilson, PA-C.

While TAVR offers hope for those at high risk, the procedure isn’t designed for everyone. Very specific criteria must be met to become a candidate, including not being well enough for the open-heart procedure, and its use is closely regulated. 

David Trader, of Snow Hill, says his recent TAVR experience was life-saving and life-changing. Before having it done, he didn’t know where his next breath would come from.

“I couldn’t believe it,” he said. “As soon as I woke up, I could feel the difference. I had no pain, no shortness of breath; I felt like I could do anything I wanted to.”

Trader was able to leave the hospital in a couple of days. “I have a small farm in Snow Hill with seven acres of grass to cut. It wasn’t too long afterward that I was able to be out there taking care of it.”

Now he’s keeping his heart healthy with one of his favorite hobbies, walking the Boardwalk in Ocean City. “This has been beyond anything I expected,” he said. “There’s nothing to hold me back — it’s the greatest thing I’ve ever done.”

Jeanne Ruff, executive director of PRMC’s Guerrieri Heart & Vascular Institute, said she’s so proud of the PRMC team. It’s wonderful to know patients like Trader have access to such great care so close to home.

“You have a talented, experienced, well-credentialed group of surgeons here on the Delmarva Peninsula,” she said. “You can get no better service in any other setting.”

 

PENINSULA REGIONAL CV SURGICAL

410-546-1353

peninsula.org/cvsurgical

 


There are no comments. Be the first to post a comment.