SEATTLE, Oct. 29, 2003 -- In early October 2003, Swedish became the first hospital in the Northwest to begin using new, fully integrated endoscopic surgery suites that utilize voice-activation technology to increase the types and efficiency of minimally invasive surgeries that Swedish-affiliated surgeons are able to offer patients. The two high-tech operating rooms (OR) are located in the main surgery unit of the First Hill campus.
Featuring equipment developed by Stryker Corp., the new ORs are among the most technologically advanced adult surgical suites in the region. Swedish surgeons are already using the sophisticated medical and information technologies to perform less invasive, camera-assisted surgeries. Surgeons use voice commands available in the OR's audiovisual system to adjust cameras, focus images, digitally record the operation and perform many other functions to assist in surgery. The rooms are also equipped with new teleconferencing capabilities that will soon 'narrowcast' surgeries over secure lines to digitally wired classrooms and conference rooms across the medical center, the region or the world.
For ergonomic and mobility reasons, the new surgical equipment is located on a ceiling-mounted suspension system. Now, staff can easily move surgical towers because they don't touch the floor. Among other things, the new ORs are increasing productivity of Swedish clinical and support staff, improving procedural efficiency and reducing overall surgery costs.
This $785,000 project was funded by an anonymous grant.
Endoscopy and Minimally Invasive Surgery
Endoscopy is the general term for examination of the body's interior with an endoscope -- a thin, flexible tube with a camera and a light source at the tip. Endoscopes allow physicians to look directly at internal organs without making incisions. Originally developed as a diagnostic tool, endoscopes are used to collect tissue samples for biopsies, perform operations such as polyp or tumor removal, cauterize blood vessels or remove gall bladders. Laparoscopy involves the use of rigid scopes to view abdominal organs and perform surgical procedures.
Minimally invasive surgery (MIS) is much less traumatic than conventional open surgery, as the surgeon only requires very small incisions in the patient's body to successfully perform an operation. The surgeon uses an endoscope to allow the anatomy and operation to be viewed on video monitors. MIS results in shorter hospital stays, faster recovery times and reduced costs.
Swedish conducts more than 1,200 minimally invasive abdominal and thoracic surgeries each year.
The new ORs are currently being reserved for Level-1 procedures, which are the most complicated. Among others, they include minimally invasive chest surgery; laparoscopic gallbladder surgery, appendix or colon removal; kidney removal for tumor or transplantation; minimally invasive procedures for urologic conditions; minimally invasive diaphragmatic hernia repair; and minimally invasive gynecologic surgery.
The EndoSuite™ OR involves integrating Stryker medical video equipment with a ceiling-mounted suspension system. Two key components of the new ORs are a Stryker voice-controlled system called Sidne (Stryker Intelligent Device Network) -- the world's first FDA-approved system capable of networking medical equipment in the OR -- and the SwitchPoint™ central control system. These systems provide surgeons with comprehensive access to and control of critical devices, in conjunction with networked digital documentation and wide-scale telemedicine capabilities.
In MIS, the surgeon uses both hands to manipulate special instruments to perform procedures. A registered nurse, under the verbal direction of the surgeon, traditionally controls all other medical devices used during the surgery. This may result in misunderstandings, unnecessary waiting periods and undue stress. With Sidne, the surgeon has direct control over all the medical equipment via his/her own voice. Sidne can activate equipment, document findings with pictures and/or motion video and dictate notes directly to the hospital network. This improves team efficiency and reduces operating time, shortening the period a patient must remain under anesthesia.
A leader in endoscopic imaging, Stryker created the first soakable camera in 1989, followed by the first three-chip camera later that same year. The company has developed the first medically approved flat-panel displays designed around the specific needs of MIS procedures. These flat panels display brilliant, high-resolution digital and analog images. A typical system has two to six flat-panel monitors hanging from ceiling-mounted arms. Advanced mobility allows the surgeon to bring the image right up to the surgical field rather than many feet away.
Stryker systems also incorporate an advanced digital-capture device that revolutionizes surgical documentation by digitally converting still images, motion videos and dictation to a CD, DVD or hospital network. Information may be captured, annotated and securely saved directly into patient records. A surgeon can also record images or high-resolution video for part or all of the case and provide a copy to the patient.
Emphasis on Teaching
In the near future, Swedish's EndoSuite operating rooms will connect with conference rooms, other hospital campuses and secure computer networks via an integrated video/data routing system. Digital routing will allow surgical images, audio notes and other patient data to be directly downloaded to a secure patient file on a central server.
"With the EndoSuite operating rooms, surgical residents and other clinicians can observe what is taking place both inside and outside the patient at the same time," explained Swedish-affiliated thoracic surgeon Ralph Aye, M.D. "This really helps us develop their professional skills."