WATERLOO — In the business world, a health-related layoff can put company profits on the critical list.
The two largest hospital systems in the Cedar Valley are addressing that problem, turning high-tech procedures into shorter stays for patients.
Allen Hospital, for example, is using robotic technology to avert knee-replacement surgery that could require time-consuming occupational therapy and a long convalescence.
A robot from Mako Surgical Corp. of Fort Lauderdale, Fla., helps surgeons replace bone lost to osteoarthritis, which is degenerative and progressive. It is a computer-controlled arm for reshaping bone, similar to computer-controlled machine tools for working wood or steel. A camera and computers on the pedestals help the surgeons tell the arm everything it needs to know before it cuts anything. The software is driven by detailed CT scans of the patient’s knee, helping the system identify what bone goes and what remains.
With the da Vinci Surgical System, surgeons at Allen now have an alternative to both traditional open surgery and conventional laparoscopy, putting a surgeon’s hands at the controls of a robotic platform. The da Vinci system enables surgeons to perform complex procedures through very small incisions. It has been used in more than 60 hysterectomies since the hospital brought it in last year, and has potential in other surgical applications in the future.
The two systems can cut patient recovery time dramatically. Workers can be back on the job in days rather than weeks or even months, according to Jennifer Friedly, director of surgical services.
“There’s much less physical therapy,” she said, discussing the Mako system, which the hospital brought in at the end of September. “Patients are up the next day. The typical stay in the hospital for a total joint is three to four days. It’s much quicker recovery.”
The procedure averts the necessity of replacing all tissues, as in a total knee replacement, Friedly said.
“It’s a much smaller area, maybe one or two compartments as opposed to the whole knee,” she said.
Less-invasive procedures and shorter recovery times have long been a goal in the medical profession. Now they’re becoming reality, said Steven Slessor, Allen’s senior director of strategic development.
The hospital has invested $1.4 million on the da Vinci technology and about $800,000 on the Mako robot, he said.
“That’s the trend we started when we bought the da Vinci,” he said. “The big technology elements that we’re investing in now are designed to get people back to normal function much quicker.”
“The Da Vinci has done that with our hysterectomy market in gynecology, and we expect Mako to do the same thing in orthopedics,” Slessor said.
Similar advancements are occurring at Wheaton Franciscan Healthcare, which has Abiomed’s Impella 2.5 Percutaneous Circulatory Support System. It provides quick, effective treatment for heart attacks, said Dr. Richard Valente, an interventional cardiologist at Covenant Hospital in Waterloo.
“Somebody comes in with a heart attack, and you have to open their artery and the heart muscle has been weakened,” he said. “You can go inside the heart, and it can take the blood out of the heart and pump it to the rest of the body at an almost-normal rate.”
The device takes stress off the heart muscle for a few days, allowing it to heal, Valente said.
“This allows the heart to rest and pumps blood to the vital organs while it heals.”
An otherwise high-risk procedure is much safer, and the patient has a much higher survival rate, Valente said.
“It’s all done with a little incision in the leg,” he said. “It doesn’t require cracks in the chest or cuts in the sternum. When we’re done with the procedure, we pull it out and hold pressure on the vein and you’re good to go.”
The procedure also can spare patients a trip to the Mayo Clinic in Rochester, Minn., or the University of Iowa Hospitals in Iowa City.
The hospital has had this technology for about two months, Valente said.
“The patients that benefit the most are ones that have weak heart function and need their arteries fixed with stents,” he said. “There will be lots of procedures using this device in the next year. It’s an overnight stay as opposed to weeks.”