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— A patient is undergoing
an operation to remove a tumor. The surgeon, radiologist and
pathologist all can see the patient clearly and consult about
the best course of action as the surgery progresses.
While this scenario sounds like it is from either a science
fiction movie or a crowded operating room, it’s actually
the unique “telemedicine” hookup at Monmouth Medical
Center that makes timely collaboration among specialists easier
than ever before.
“Monmouth Medical Center is the only hospital I know of
in which the operating rooms are connected via audio and video
to the Pathology and Radiology departments, as well as the Emergency
Department, Intensive Care Unit, auditorium, Department of Surgery
office and the Internet,” says Michael A. Goldfarb, M.D.,
FACS, chairman and residency program director of the Department
of Surgery. “Other hospitals have similar hookups between
two departments, but Monmouth is the first to link all these
crucial areas of the hospital.”
This new “360-degree concept” of the operating room
is an initiative that Dr. Goldfarb instituted in four Monmouth
ORs, which were equipped with built-in flat-screen monitors and
pull-down accessory modules to accommodate any type of surgery
that uses a television screen. Monmouth Medical Center, an affiliate
of the Saint Barnabas Health Care System, is one of the leading
minimally invasive surgery centers in the nation, performing
more than 3,000 such cases annually.
In addition to the various connections within the hospital,
Dr. Goldfarb notes he is able to connect to the entire system
from his home — connectivity that soon will be expanded
to other Monmouth surgeons. “I have already done 12 remote
intraoperative real-time webcast consultations with successful
outcomes,” he adds.
These high-resolution flat-screen monitors allow microscopic
views and X-ray images to be seen simultaneously by the surgeon,
pathologist and radiologist. As a result, the pathologist can
better determine the exact location and margins of tissue that
the surgeon will biopsy or remove. Also, the radiologist and
surgeon can share and compare X-ray images immediately.
Monmouth hematopathologist Plamen Kossev, M.D., explains that
a high-quality digital image of a microscopic slide can be sent
as an immediate frozen section from the hospital’s Laboratory
to the OR either directly or via the Internet.
“The pathologist is able to see, in real time, the tissue
a surgeon will biopsy or want to remove, and, because of the
interconnection, the surgeon in the OR also can see the tissue
the pathologist is examining,” he says.
Adds Dr. Goldfarb: “The surgeon can even see frozen section
slides used by pathologists to evaluate benign or malignant samples — offering
the closest possible line of communication with our pathologists
in the most rapid and complete fashion. This team approach in
the operating room will improve and expedite care.”
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