Beebe Medical Center forms new department of minimally invasive surgery

June 28, 2013

In order to offer the most advanced care for the surgical patient, Beebe Medical Center has formed a department of minimally invasive surgery to further implement its commitment to instituting minimally invasive surgical techniques when medically appropriate. Such techniques can produce less pain, less bleeding, and a faster return for the patient to his or her daily responsibilities. These surgeries also offer significant cost savings to healthcare, employers and patients in a time of cost-benefit importance.

Beebe surgeons and hospital staff have worked together to design renovations in the Operating Rooms to assure the safest environment for the patient. The renovated surgical suites use the latest in imaging-guided, fiber-optic and high-definition cameras and equipment to assure quality outcomes.

Beebe Medical Center now offers a minimally invasive approach in multiple surgical specialties including: gynecological, oncologic, urological, orthopaedic, gastrointestinal and cardiovascular.

The surgeons at Beebe Medical Center continue to train on the latest technologies, and have pioneered many of the available laparoscopic procedures. The minimally invasive surgery department also offers a wide variety of care and training opportunities for surgeons.

Orthopaedics

Hard work and dedication has led to the hospital and surgical services being awarded many honors in orthopaedic surgery - Beebe Medical Center received the Orthopaedic Surgery Excellence Award for seven years in a row. A national study ranked Beebe Medical Center No. 1 in Delaware for Overall Orthopaedics and Best on the Delmarva Peninsula for Overall Orthopaedics.

Beebe Medical Center's James P. Marvel Jr. Orthopaedic Unit provides comprehensive orthopaedic services and programs designed to treat injuries and conditions affecting bones, muscles and joints. Arthritis, sports injuries, and back pain are common reasons for seeking help from an orthopaedic surgeon. Thirteen board-certified orthopaedic surgeons are members of the Beebe Medical staff. They are highly qualified to treat a wide range of orthopaedic problems, and many of those problems requiring surgery can be done arthroscopically. Such procedures are performed by inserting an arthroscope, a specially designed illuminated device, into the joint through a small incision. Arthroscopy allows a patient to return home sooner after surgery, with less pain and a quicker recovery than with open surgery.

 

Women's Health

Beebe Medical Center is the first hospital in Delaware and on the Delmarva Peninsula - and one of only 12 in the United States - to be named a Center of Excellence in Women’s Health by the American Institute of Minimally Invasive Surgery (AIMIS).

Three Lewes surgeons and members of the Beebe Medical staff — Vincent B. Killeen, MD; Steven D. Berlin, MD; and Leo H. Eschbach Jr., DO — have been recognized and accredited for their expertise in minimally invasive gynecologic surgery by the AIMIS, which also has designated their private practice, Bayside Health Association Chtd., as a Practice of Excellence.

This recognition by AIMIS means that Beebe Medical Center, together with Drs. Killeen, Berlin and Eschbach, offer laparoscopic and minimally invasive gynecologic surgery, particularly laparoscopic hysterectomy, that have produced excellent patient outcomes and meet the highest standards of quality and safety as set by the AIMIS.

“Being recognized as a Center of Excellence is exciting, but what’s rewarding is that it shows we’re doing what’s best for our patients,” said Jeffrey M. Fried, president and CEO of Beebe Medical Center. “The physicians at Bayside have pioneered many of these laparoscopic techniques that lead to optimum outcomes for our patients, and they’ve shown a true commitment to bringing these leading-edge technologies to Beebe Medical Center.”

Hysterectomy may involve removal of the uterus, the uterus and the cervix, and, for some conditions, the fallopian tubes and ovaries. Each year, more than 600,000 women undergo the procedure, with one in three women in the United States undergoing the surgery by age 60. Open hysterectomy usually requires patients to spend three to four days in the hospital and up to six weeks recovery from a painful abdominal incision. With only tiny incisions, laparoscopic hysterectomy allows patients to go home the same day, and they can resume normal activity in one to two weeks.

Dr. Berlin, who, until recently was chief of obstetrics and gynecology at Beebe Medical Center, is medical director of minimally invasive surgery. He said, “Beebe Medical Center’s division of gynecological minimally invasive surgery has become a regional referral center offering an alternative approach to a wide variety of gynecological conditions including: pelvic masses, endometriosis, pelvic pain, fibroid tumors, myomectomy, hysterectomy, menstrual disorders, ovarian and endometrial disease.”

Surgery for all of these conditions can be done laparoscopically. "Every woman is considered for minimally invasive surgery before going for open surgery," Berlin added. Many patients qualify, including those being treated for cancer.

"The minimally invasive approach to a major operation results in less bleeding, less risk of infection, less pain and a quicker return to life's responsibilities for the patient," Berlin concluded. "It's good for the employer because the employee needs less time off." And, from a cosmetic or sexuality standpoint, it's difficult enough to undergo surgery without ending up with a long scar.

Beebe Medical Center surgeons already have begun introducing minimally invasive surgical techniques to medical students. In a collaborative pilot program between Beebe Medical Center and the Philadelphia College of Osteopathic Medicine, third-year medical students have been spending a month’s rotation over the past two years in a clerkship program learning about gynecologic care, both in the operating rooms at Beebe Medical Center and in the physicians’ offices. The program has met with a positive response and the hospital has expanded the clerkship program from obstetrics and gynecology into other areas.

Bariatrics

Beebe Medical Center also holds the designation of a Bariatric Surgery Center of Excellence that focuses on quality outcomes for patients. Patricia Houston coordinates services for patient care for the bariatric surgery program between the hospital and the surgical practice of Drs. Michael Sofronski and Daniel McCullough at Delmarva Bariatric Center in Rehoboth. Houston said one of her responsibilities is to make sure the program maintains its accreditation as a Bariatric Surgery Center of Excellence, which focuses on quality outcomes for patients. The center of excellence program is a collaboration between the hospital and the surgeons' office. "We offer nutrition education, a fitness program and monthly support groups," Houston said. 

The term bariatric surgery refers to any surgical weight loss procedure, Houston explained. Beebe offers three options: the adjustable gastric band, gastric bypass and sleeve gastrectomy, a procedure that creates a small stomach to limit the volume of food a patient is able to eat. Part of the stomach is removed, which causes changes to the patient's appetite. Only the gastric band procedure is reversible.

"These procedures have been around a long time," Houston said. "Insurance companies are beginning to accept and pay for them, so we are seeing an increase in the number of patients. Research shows surgery offers very good outcomes with patient weight loss and improvements in health complications related to weight such as diabetes, high blood pressure and sleep apnea."

Drs. Sofronski and McCullough perform each of the three procedures as minimally invasive surgery. Done laparoscopically, surgery requires only five or six small incisions. 

Oncology

Chia-Chi Wang, DO, a fellowship-trained surgical oncologist, recently joined the Beebe Medical staff, leading to the expansion of the hospital’s surgical oncology program. Wang joins surgical oncologist James E. Spellman Jr., MD, in seeing patients at the Beebe Health Campus in Rehoboth Beach. 

Wang said the evolution in the surgical field has led to increasing possibilities of minimally invasive surgeries, such as small bowel, colon and gastric resections. Not every patient is a candidate — those with bulky tumors may not be, she said. "We have to select patients carefully. Performing oncologically sound surgeries is our priority. We evaluate each patient's condition individually and decide if minimally invasive surgery is applicable to his or her cancer surgery."

Performing abdominal surgery through smaller incisions has advantages, she said, citing less incision pain, less adhesion formation and, in particular, an earlier return to normal bowel function.

For a lung cancer resection, traditional surgery required a large incision and severing a rib. "Now we do video-assisted thoracic surgery (VATS). VATS accomplishes the same result with less pain and no rib severed," Wang said. 

Patients also are able to take a deep breath easier, which lessens the chance of post-operative pneumonia. Many VATS patients are able to leave the hospital sooner and return to work and daily activities quicker compared to patients who have open surgery.

"Where I trained, 90 percent of the thoracic surgeries were VATS, and it is becoming more prevalent in community settings."

For more information on minimally invasive surgery at Beebe Medical Center, visit beebemed.org.

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