Advances in Abdominal Surgery

Technology of the ‘future’ is already making waves today.

Game-changing upgrades to current robotic platforms. High-definition imaging including 3D visualization and augmented reality tools. Specialized instrumentation for Natural Orifice Transluminal Endoscopic Surgery (NOTES) procedures.

These are just some of the advancements that are directly impacting minimally invasive abdominal surgery right now, expanding the capabilities and precision of surgeons to improve patient outcomes. Savvy surgery centers and forward-thinking surgeons are already taking advantage of the latest tools at their disposal, but these advancements are likely to soon shape the entire specialty of abdominal surgery.

It’s an exciting time to work in GI. “The future of minimally invasive abdominal surgery is being driven by a convergence of advanced instrumentation and cutting-edge technology,” says Sharona Ross, MD, FACS, director of minimally invasive robotic surgery, surgical endoscopy and the GERD and Esophageal Cancer Center at AdventHealth in Tampa, Fla. “These innovations are transforming the surgical experience for both patients and healthcare providers, leading to safer, more effective and more efficient surgical interventions.”

And as Dr. Ross points out, we’re only scratching the surface. “As these technologies continue to evolve, they hold the potential to further expand the capabilities of minimally invasive surgery and improve patient outcomes across a wide array of surgical procedures,” she says.

Keeping pace with progress

The latest high-tech medical devices are advancing at a rapid pace. With the introduction of artificial intelligence (AI), the acceleration curve of bringing in new robots and visualization equipment to improve workflows in operating rooms everywhere will only speed up.

“While the development of technology will be faster, the adoption of all of this — how well ORs can integrate these tools into their existing systems and workflows — might be the Achilles heel,” says Suraj S. Soudagar, MS, MBA, LEED AP, senior principal and client executive with IMEG Corp., a healthcare engineering firm in Naperville, Ill. “Think about your iPhone. It’s a great device, but its software keeps updating, so at some point you must update the hardware too. In a similar way, if you’re buying surgical robotics, the software will drive it, but without the right staff training and without the right room layout, there might be some underutilization of what you just purchased.”

Mr. Soudagar urges his clients who are looking to update their technology and hardware to also plan for how to update their workflows, including the layouts of their rooms, as well to increase staff efficiencies when these technologies are in actual use.

“A small room will hamper better patient outcomes that the greatest technology can bring if you need more space than you’re providing it to use it at its best,” he says.

Even as more and more technology is housed in smaller and smaller boxes, Mr. Soudagar says surgeons must keep pace and get smarter about how to use increasingly complex devices, because updating them and maintaining them becomes more complicated.

“These tools are great. Robots are extremely precise. Procedures can be replicated, and the tools can often exceed the dexterity of humans, allowing surgeons to get into tight spaces with articulating laparoscopic tips through smaller incisions than would be required for a human surgeon to get into,” he says. “These small incisions help patients heal better in the PACU and during the entirety of their recoveries.”

Like Mr. Soudagar, Dr. Ross is bullish on the untapped potential of robotic platforms, saying the integration of these systems into surgical practice has revolutionized certain minimally invasive procedures in a multitude of ways. “Robots provide surgeons with enhanced dexterity, precision and control, allowing for intricate maneuvers in confined spaces,” she says. “This technology is particularly beneficial in complex abdominal surgeries, such as those involving the pancreas, liver or gastrointestinal tract.” Robotic adoption will likely become easier as the age of the surgeon pool decreases. “Younger surgeons from the Gen Z video game generation have a lot more dexterity with their hands than the older folks who didn’t grow up with them,” says Mr. Soudagar. “In the meantime, all facilities should provide support and training for surgeons and everyone else on the team to maximize the precision and control these devices can deliver.”

New offerings keep coming

The latest version of one robotics system is much more compact than its predecessor and includes much better visualization and other tools. The cost is about the same, just under $3 million if you buy its accompanying ESU energy sources. Other robotics companies are in the marketplace with new offerings, some of which are gaining traction after rough starts because of utility issues they had to overcome.

“A Chinese manufacturer came up with a robot that was able to perform a surgery in Europe while the surgeon was sitting in China, offering a new frontier to patients of surgical skillsets from anywhere in the world,” says Mr. Soudagar. “As technology grows from 5G to 6G, the delay in the future from a doctor sitting in Chicago to an OR in London will be very minimal.”

This application could be helpful for ASCs in rural settings with sparse surgeon availability that could tap into the skills of a surgeon from an urban medical epicenter by connecting to a robot to perform surgeries. “That would not only increase access for patients who need it, but it also expands the skillsets of a surgeon to other surgeons who can observe,” says Mr. Soudagar.

AI is helping with the collection of data to boost the efficiency of other technologies that will help operating rooms run more efficiently to increase their returns on investments.

“ORs traditionally have been the most expensive real estate in a hospital in terms of the amount of technology that is packed within that space, so administrators should always seek to better utilize and operationalize it,” says Mr. Soudagar. “All surgical and ambient technologies available should be used to squeeze every single minute out of a space that is so expensive to operate. The more you maximize the utility of the OR, the better its ROI, which makes you better prepared to update that space when newer needed technologies become available.”

Be here now

By nature, both Dr. Ross and Mr. Soudagar have a future-thinking mentality regarding technology. They’ve always been on the forefront of what’s happening next. But thanks to rapid innovations on the abdominal surgery front, many of the tools, systems and instruments that facilities considered out of reach just five or 10 years ago are easily accessible right now. OSM