Thompson Hospital Leading the Region in Robotic-Assisted Surgeries
Excellent outcomes, less pain, and minimal need for post-surgery opioid prescriptions define a high-quality, growing program.
While it’s not uncommon for large, world-renowned hospitals such as the Mayo and Cleveland Clinics to receive surgical referrals from across the country, over the past decade, F.F. Thompson Hospital has quietly joined these health systems’ prestigious ranks. Without fanfare, and without the attention of the news media or major donors, Thompson has been busy building a foundation for robotic-assisted surgical excellence rivaling even the largest health networks across the country.
About 10 years ago, we acquired a surgical robot called the da Vinci Si. Designed and built by Intuitive, a global manufacturer of robotic surgical systems, the da Vinci Si robot offers surgeons enhanced imaging and intricate manipulation of the patient’s surgical site via a remote console adjacent to the operating table. The surgeon’s console is linked in real-time to the robot positioned over the patient. By maneuvering the console’s sensitive controls attached to the surgeon’s fingers, the robot follows the surgeon’s movements allowing for unparalleled surgical accuracy especially in tight angles and confined spaces.
While robot-assisted surgery is not necessarily a new concept, Drs. Joseph Talarico and A. David Peter, master surgeons in our Advanced Surgical Services Department, immediately saw the potential with Intuitive’s da Vinci technology, particularly in low-acuity procedures involving the hernia, gallbladder, and colon. They and their colleague, general surgeon Dr. Tom Wormer, began booking the da Vinci robot for more of their surgical cases as patient outcomes were clearly better.
As the practice grew over the years, general surgeons Dr. Andrew Powers and Dr. Theodor Kaufman - along with Dr. Jillian Babu of Thompson's OB/GYN practice - began employing the da Vinci robot for their patients as well.
“The utilization of robots to assist in surgical procedures is common in many esteemed healthcare institutions; it is forward-thinking medicine,” said Dr. Talarico, the director of Hernia and Robotic Center of Excellence at Thompson. “But how a hospital utilizes that technology is what truly defines its success. At Thompson, my colleagues and I are committed to maximizing usage of our da Vinci to best serve our patients.”
Enhanced Patient Outcomes
The results of this team’s visionary efforts have been nothing less than extraordinary, particularly around patient outcomes. With traditional invasive hernia surgeries, for example, a large incision can result in the patient receiving additional surgical anesthesia, a longer stay in the hospital, and higher doses and longer regimens of pain medication. Even with the utilization of a less invasive laparoscopy for hernia procedures, the patient may still endure the effects of this type of surgical procedure.
With minimally invasive robot-assisted hernia procedures and other general surgeries, the patient enjoys improved outcomes, including a shorter stay in the hospital, less surgical anesthesia, fewer complications, a quicker return to work and activities of daily living, and low or no opioid usage for post-surgery pain. For the majority of cases, patients are prescribed over-the-counter pain medication, and only if necessary.
The reduction in post-procedure opioid prescriptions by Thompson surgeons using robotic surgical assistance cannot be overstated, particularly with the misuse - and sometimes illegal use - of narcotics in the United States and other countries. Several years ago, Drs. Talarico and Peter did a deep dive into their patients’ need for pain management following a da Vinci hernia procedure. The results clearly showed there was no need (or a greatly reduced need) to prescribe opioids to their surgical patients, so the surgeons simply stopped prescribing them. This was not a common practice at the time; however, as positive outcomes continued their growth skyward, more and more surgeons began to follow suit.
The Dramatic Increase in Surgical Volumes
In 2020, we upgraded our da Vinci Si robot to a newer model, the Xi. This new iteration of da Vinci features more precise, smaller, narrower robotic arms with redesigned joints that enable greater range of motion. Positive patient outcomes with Thompson’s Xi robot continued their upward trajectory first established with the Si years before.
From the hospital’s perspective, using the da Vinci Xi robot for general surgical cases when appropriate has dramatically increased the number of procedures able to be scheduled in the operating room. Robotic-assisted cases are safer, more efficient, and faster than traditional invasive procedures. This means Thompson can safely conduct an average of five da Vinci surgeries each day compared to two or three using traditional techniques.
In 2022, Thompson conducted 620 procedures utilizing the Xi robot, an increase of 20% from the prior year, which skyrocketed our 113-bed hospital to the 97th percentile in the United States. What is more telling, these volumes were achieved primarily by two surgeons, Talarico and Peter, using a single Xi robot on cases mostly involving the hernia. According to its manufacturer Intuitive, “the Thompson da Vinci Xi robot is one of the highest-utilized in the country which is quite an accomplishment for a community hospital.”
It is this ever-growing volume that is helping our surgeons become the leaders at robotic-assisted surgery, as well as being sought out by more and more patients around the country. Patient word-of-mouth has spread like wildfire, reaching as far away as California.
“We regularly receive inquiries from prospective patients from all over the United States,” said Dr. Peter, our Medical Director of Robotic Services. “In the past, these types of inquiries were typically reserved for large, well-known hospitals in metro centers. This is definitely not the case with Thompson; we are competing with and exceeding the success rates of the big players.”
Thompson’s success played a key role in the hospital becoming a designated Center of Excellence for both hernia surgery (2016) as well as Robotic Surgery (2017) by the Surgical Review Corporation (SRC), a nonprofit, accrediting body. Thompson was the first healthcare facility in the state to attain the hernia designation.
Cindy Vanderhoff, Senior Manager of Clinical Quality and Compliance at SRC, was on the Thompson campus this past February for the hospital’s Center of Excellence reaccreditation process. Following her report, which included zero deficiencies, Cindy commented, “Thompson has a lot to be proud of; you have an outstanding program with outstanding outcomes. It was difficult to find areas of improvement in such a professional and dedicated environment.” Cindy also spent time reviewing Thompson’s Sterile Reprocessing Department, which is instrumental in surgical cases. She commended the department for its stellar work in relation to Xi procedures.
Community Outreach Key to Growth
Also driving Thompson’s growth in utilization of the da Vinci robot, particularly around hernia surgeries, have been our public hernia screenings. Previously, a hospital conducting public screenings for hernia was unheard of; now it is more common. This is thanks to Dr. Talarico who first envisioned hernia screenings at Thompson Hospital in fall 2016. Conducted within the hospital’s cafeteria due to its available space, our inaugural hernia screening maxed out at capacity of 40 guests. Subsequent screenings held in different venues across the Finger Lakes, including a virtual screening during the height of COVID, similarly resulted in a high level of community interest.
“The surgeons at Thompson have the full and unwavering support of the entire executive leadership team,” said Kurt Koczent, Executive Vice President and COO at Thompson Health. “Events such as hernia screenings demonstrate the commitment our surgeons have to the health of our community; it is one of the reasons Thompson excels at delivering top-notch patient outcomes.”
During these well-attended public events, Drs. Talarico, Peter, and Powers meet one-on-one with guests to answer questions and concerns, as well as conduct private screenings on-site to determine the potential patient’s status and whether he or she could benefit from a noninvasive surgical procedure with the da Vinci robot. One of the highlights of the in-person screening events includes potential patients manipulating a mobile version of the robot so they can understand how it assists the surgeon during the hernia procedure. Both the screening and hands-on portions of the event help develop a strong level of trust between the potential patient and the surgeon long before the procedure takes place.
We are conducting our next scheduled hernia screening event on Wednesday, October 4, 2023 from 5:30 to 7:30 p.m. at Ferris Hills at West Lake, Thompson’s independent living senior community located at 1 Ferris Hills/Peg Rayburn Drive in Canandaigua. Interested individuals can register at www.ThompsonHealth.com/hernia. There is no fee to participate in this event; however, space is limited – slots will be filled on a first-registered, first-served basis. If you have any questions, or for more information, contact Nancy_Church@URMC.Rochester.edu or call 585-396-6375. New to the team this year is robotic-certified general surgeon Dr. Brad Hensley who will also be seeing patients at the screening.
While location, size, and prestige oftentimes are the cornerstones of a health system establishing itself as a leader in medical and surgical advances, it is not always the case, as Thompson demonstrates time and again. With our single da Vinci Xi robot and small cohort of master and general surgeons, our facility has surpassed some of the largest and most distinguished hospitals in the United States when it comes to robot-assisted utilization and patient outcomes. It is these results that drive our community hospital’s surgical success and help fulfill our vision to become the leading community healthcare system in western New York.