Outpatient Surgery Magazine

Innovations in Surgery Supplement - February 2018

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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A D V E R T O R I A L Brought to you as an educational service by Let There Be Light A simple device made a big difference for this surgeon, his staff and his patients. A Q&A with John H Marks, MD makes it different is a switch that activates a powerful LED light near the tip. It directly lights the tissue you are manipulating. Because of that, I no longer worry about hands and heads dimming my light source. No more headlight-induced neck pain. Now, when I'm dissecting into the plane between the external and internal sphincter and between the mesorectum and puborectalis, I can clearly see what I'm doing and much more easily stay on the oncology plane. I'm much less worried about straying into nerves or blood vessels or the tumor itself. I'm also much more relaxed and comfortable. It's better for me and for my patients. Q What about economic considerations? Does the NOVA add a lot to case costs? A Just the opposite. Because we do not have to fiddle with the lights and speculum as much to achieve exposure, the NOVA has a very favorable economic impact. It might save us 15 to 30 minutes on the first part of the procedure, and in the OR, time is money. Q Anything else surgical professionals should know? A We have a lot of great technology today, including robots and 4K video. But sometimes the simplest ideas can still make a very big difference. For open cases in dark places, this device is definitely worth a try. E veryone knows that when surgeons see well, they do well. A brightly illuminated surgical field enables safe, efficient, comfortable surgery. But how is that possible when the surgical field is deep, dark and cramped, as it is in as in open head and neck, deep pelvis, mouth, axilla, chest, and rectal surgery cases? One answer is the Paré NOVA hand-held surgical light with cautery. Its built-in light allows surgeons to see exactly what they're working on without straining. To find out how it works in practice, we asked John H Marks, MD. He is chief of Colorectal Surgery for Main Line Health at Lankenau Medical Center near Philadelphia. Q What kind of surgery do you do in your practice? A All sorts of laparoscopic and robotic colorectal surgeries; I've performed over 3000. But we are best known for our treatment of patients with rectal cancer. In traditional rectal cancer surgery, one in three patients ends up with a permanent colostomy. With a special procedure that we perform laparoscopically called TATA/taTME, only 7 percent need a permanent bag. Q What do you do differently? A We perform the first part of the procedure in NOTES fashion--through the anal opening rather than from the top down. Q That sounds like a difficult space in which to work. A It used to be very difficult a few years ago, when our only illumination came from overhead lights and surgical headlights.OR lights are subject to obstruction from hands, heads and specula. We found ourselves constantly stopping to reposition the speculum to allow more light into the operative site. Headlights helped, but over a long procedure they are an ergonomic nightmare. Q What changed? A Now we have the NOVA. It has made a major difference for us. At first glance, the NOVA looks and feels like a traditional electrosurgical handpiece, with buttons where you expect for coagulation and cutting. What IT'S MUCH EASIER TO SEE IN DEEP DARK SPACES WITH THE NOVA, SAYS SURGEON JOHN MARKS, MD. NOVA is distributed by Pare Surgical, Centennial, CO: www.pare.net.

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