Section: Saint Barnabas Medical Center News

Two New ORs: Cutting-edge Facilities Increase Capacity and Accommodate Tomorrow’s Technology

05/16/2016

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.

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 surgeon fatigue.

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.

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