The medical center adds cutting-edge facilities to increase surgical capacity
by 20 percent and accommodate tomorrow’s technology.
How does a hospital show its commitment to the future? With words, for
sure—a clearly articulated statement of mission is important. But
action counts too. And these days, construction busily under way on the
Saint Barnabas Medical Center campus is proof positive that the institution
is growing to meet tomorrow’s needs and is supporting that effort
with major resources. Four new operating rooms are being added that are
designed to fit well not just with today’s latest technology, but
also with the innovations of years to come.
Surgeons, of course, want to perform in a state-of-the-art environment
that allows them to use their skills to their fullest. That’s what
the new facilities will do. “With these new ORs, patients in the
region don’t need to go anywhere else in New Jersey or New York
for the highest-quality surgical care,” says
Ronald Chamberlain, M.D., chairman and surgeon-in-chief of the medical
center’s Department of Surgery.
The new operating rooms represent a $14 million investment by Saint Barnabas
Medical Center, with a budget for new technology of an additional $3 million,
says Dr. Chamberlain. “Medical technology advances day by day, like
new apps for smartphones,” he says. “These ORs are planned
to anticipate new technology for the next decade in terms of their size
and shape and the ability to accommodate new imaging systems. They are
also designed to meet the future, as more and more procedures and specialties
move from open surgery to more minimally invasive options.”
In all, the new ORs add about 30 percent more space, he says. This will
allow surgeons to perform up to 40 more procedures a day on top of the
90 or so they were able to schedule before the expansion. And the improvements
will enable the medical center to renovate existing rooms.
Perhaps the showpiece of these new rooms is the hybrid OR. It allows surgeons
to perform minimally invasive cardiac, vascular and neurological operations,
with the option of converting quickly to open surgery should that need
arise. “This OR in itself represents a $6 million investment,”
Dr. Chamberlain says. The principal procedure performed here, at least
for now, is transcatheter aortic valve replacement, or TA VR. (See page
42.) TA VR involves two surgical specialists, a cardiac surgeon and an
interventional cardiologist, who work in tandem. The hybrid OR affords
them and their assistants more room and has a specially designed operating
table that converts quickly from an interventional to an open surgical
platform. It also houses the high-tech imaging equipment needed for these
types of operations.
Counting this closed, radiation-proof control area, the Hybrid Room, largest
of the new operating rooms, measures 1,195 square feet. For radiology
images, the PACS (picture archiving and communication system) is available
on 55-inch screens in all four new ORs, and all have video broadcasting
capabilities as well.
Another new OR is perfect for brain procedures. “It allows neurosurgery
to move into the modern era as it makes the transition to minimally invasive
and robotic brain surgery,” he says. This room is built to house
an MRI imaging system, which allows neurosurgeons to perform what is known
as stereotactic radiosurgery— a technique that despite its name
actually uses radiation, not a knife, helping the doctor pinpoint the
precise location of any tumor that needs to be removed. This means he
or she needs only make small openings in the skull, thus avoiding craniotomy—
the removal of a portion of the skull—and its attendant risks of
infection and longer healing time.
The other two ORs are also better adapted to the future of laparoscopic
and robotic surgery.
Thad R. Denehy, M.D., a gynecologic oncologist at Saint Barnabas, says the new rooms, with more space and two surgical
robot systems (including the very latest model, the daVinci Xi), are “very
exciting. They give us more opportunities to operate, of course. These
two rooms are much larger than our standard operating rooms and specifically
designed for the robots, with all the amenities and materials and instruments
in permanent rooms rather than being switched from room to room or in
a converted room. The design helps maximize the work flow needed to use
the robot, and can accommodate increased numbers of staff as well as the
new large amounts of equipment required for some of the more state-of-theart
and more complex surgeries.”
The ORs also make video conferencing available, with video equipment built
into the laparoscopic towers to transmit images of the surgery. Dr. Denehy
also appreciates the improved ergonomics and support structures, such
as booms, that make using the latest equipment easier and help prevent
Dr. Denehy says he performs more than half of his surgeries using the robot
now. That number should only increase. “A study released in March
that assesses the benefits of robotics compared 3,000 cases across four
gynecologic surgical approaches. It found that patients having robotic
benign hysterectomies had better outcomes and fewer complications compared
with those undergoing conventional operations. This was true even though
they were often more complicated surgeries. They still had better outcomes
and less pain. That is why robotic surgery is overtaking other approaches.”
These ORs allow orthopedic and other specialist surgeons to perform cutting-edge
robotic procedures too, Dr. Chamberlain says. “People come to where
the technology is, and surgeons want access to that technology.”
To be sure, one reason for these new ORs is to provide for more surgical
volume, especially same-day and outpatient surgery, which is growing rapidly.
The OR expansion is the first of three phases of growth at the medical
center, Dr. Chamberlain says, and a new hospital building under construction
will house some inpatient and outpatient services, for which these rooms
will be used.
Saint Barnabas Medical Center’s surgical roster includes 364 staff
surgeons, he says. “The neurosurgery staff has grown by 700 percent
and the thoracic surgery staff by 100 percent,” he says. About 25
new OR nurses, tech and support staffers have also been added recently.
In all, these improvements put Saint Barnabas at a level equal to the best
medical centers in the country. “They show that Saint Barnabas is
investing in the future, and in better care and outcomes for patients,”
says Dr. Denehy.