6 surgical innovations defining ASCs

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The ASC industry has seen distinct surgical advancements in specialties such as cardiology and spine, allowing for more procedures to move to the outpatient setting. 

Ten ASC leaders and surgeons spoke with Becker's ASC Review on the surgical technique/ device that has had the most influence on their practice. 

1. Surgical robots

Adam Spiegel. CEO of NorthStar Anesthesia (Irving, Texas): Robotic surgery in the ASC environment is a novel approach with a very significant impact on our anesthesia practices. Recently, we've seen an increase in the adoption of robotic surgery techniques in orthopedics, general surgery and gynecology. There are many factors, like positioning, fluid and electrolyte issues, and pain management, that require well-trained anesthesia providers to support these increasingly complex procedures in the ASC environment.

Alfonso del Granado. Administrator of Covenant High Plains Surgery Center (Lubbock, Texas): We frequently see new techniques and equipment coming our way, but most are incremental improvements over existing standards. The only truly novel innovation that could qualify as a paradigm shift is the introduction of surgical robots into the ASC space, and it remains to be seen whether the overall impact will be as substantial and lasting as the original conversion to minimally invasive surgical techniques that started more than 30 years ago.

Frank York. CEO of NewSouth NeuroSpine (Flowood, Miss.): The most impactful surgical technique is robotics usage in lower lumbar fusions and scoliosis cases, as utilization can provide greater accuracy in placement while decreasing radiation exposure to both patient and surgical staff.

2. Cervical disc arthroplasty

Andrew Lovewell. Administrator of Surgical Center at Columbia (Mo.) Orthopaedic Group: Cervical disc arthroplasty has seen a tremendous growth in recent years due to technological advances with implants that recreate the natural structure of the spine while preserving flexibility and relieving pain. Many patients that once had to have a fusion that may result in further future surgeries can now have the disc in their neck replaced. The procedure is minimally invasive, but also more cost effective than a traditional fusion. On top of that, many of our patients have a same-day discharge, no complications, faster return to work and immediate relief. 

Adam Bruggeman, MD. Surgeon at Texas Spine Care Center (San Antonio): The most important changes in the last few years have been the advancement of disc replacement in the cervical spine and the use of perioperative treatments and protocols to reduce pain and allow for earlier transition to home.

3. Minimally invasive sacroiliac joint fusion 

Andrew Lovewell: Minimally invasive sacroiliac joint fusion is another procedure that has seen dramatic growth at our practice. SI joint pain was previously a nonoperative type of pain that many patients had to live with for years. However, with new technology, many patients that suffer from SI joint dysfunction or disruption may be candidates to have an SI joint fusion. The procedure has an extremely small incision that allows just enough room to implant the devices that are needed to fuse the SI joint together. All of our patients have a same-day discharge just a few hours after the surgery, and patients require significantly less recovery time than an open SI joint fusion. 

4. Femoral neck solutions

Anthony Bevilacqua, DO. Surgeon of Sports Medicine & Orthopedic Center (Suffolk, Va.): The Femoral Neck System has changed the way we treat certain femoral neck fractures. In the past, we used cannulated screws but would have the patient not bear weight. For elderly patients, this often resulted in them not doing much for three months during healing. Now, with this system, the surgery is every bit as simple, but weight-bearing as tolerated is permitted, and this significantly impacts patient mobilization and recovery.

5. Outpatient coronary stents 

David Horace. Administrator and Owner of Bel-Clair Surgical Center (Belleville, Ill.): Outpatient coronary stents have been shown to move the needle in facilitating cardiologists to shed the shackles of hospital captivity and make the transition to the ASC environment where their earnings potential is much greater since they have access to technical component revenue.

6. Ulnar collateral ligament reconstruction of the elbow

Timothy Kremchek, MD. Surgeon of Beacon Orthopaedics & Sports Medicine (Cincinnati): By far, other than advances in arthroscopic surgery, the ulnar collateral ligament reconstruction of the elbow and the advances in rehabilitation with that procedure have been a game changer. Being able to allow these youngsters to continue their careers and, in some cases, fulfill their lifelong dreams has been very rewarding.

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