This spring, the University of Alabama at Birmingham surpassed the 10,000 robotic surgeries mark, a feat that helps make UAB the leader in robotic surgery volume in the country. For surgeons within UAB Medicine, a collaborative spirit and the willingness to work together across many disciplines helped push the hospital over this milestone and into a new frontier of surgery.
“Surpassing 10,000 robotic surgeries is reflective of a joint commitment made by many surgeons and hospital administrators alike to demonstrate UAB’s mission pillars, from education to innovation, community engagement to patient care,” said Jeffrey Nix, M.D., assistant professor in UAB’s Department of Urology and associate scientist at the UAB Comprehensive Cancer Center. “We are constantly thinking through how as a team we can continue to enhance patient experiences and make innovative strides in our respective fields, which ultimately reflects back on UAB as a leading health care provider.”
At UAB, robotic surgery is a cornerstone in many disciplines, including urology, cardiothoracic surgery, endocrine surgery, gynecologic oncology, general surgery, otolaryngology, head and neck surgery, and surgical oncology, as well as women’s reproductive health. Rather than focusing efforts on select specialties, the well-rounded approach promotes cross-collaboration among surgeons and has helped UAB push the envelope with technology to provide patients unmatched minimally invasive, quality surgical care.
“What makes our approach unique is that a patient may need to have rectal surgery, while at the same time part of his bladder may need to be removed,” Nix said. “Instead of having to have two surgeries that require separate and challenging recovery periods, we can complete both in one surgery through minimally invasive methods that speed up recovery time, cause less pain and leave minimal scarring. Across departments, we are constantly communicating and working together to deliver the best care possible.”
In reaching the 10,000 surgeries, UAB surgeons have gone beyond just performance to make lasting impacts on the field and future of robotic surgery. For instance, William Carroll, M.D., chair of UAB’s Department of Otolaryngology and senior scientist at the UAB Comprehensive Cancer Center, notes that the department has been pivotal in the support of head and neck cancer robotic surgeries, as data collected at UAB were used by the federal Food and Drug Administration to grant approval for robotic surgeries of the head and neck specifically. Renowned surgeons like Robert Cerfolio, M.D., former chief of Thoracic Surgery at UAB, have helped to develop guidelines and standards that have and will continue to influence the field as we know it.
Another unique aspect of UAB’s robotic surgery division includes one-of-a-kind training to which only UAB residents have exposure. In noticing that most residents had access to robotic training only once a year if at all, Kenneth Kim, M.D., associate professor in the Division of Gynecologic Oncology, was tasked with revamping the existing robotic surgery training curriculum.
“Surgery in its basic form is a combination of skill and technique, used in a logical fashion to complete a surgery safely and successfully,” Kim said. “It’s critical that, in addition to learning the ‘how’ of procedure basics, residents are learning the ‘how’ in surgical tools and techniques. The how – in conjunction with consistent simulation to training — is what enables residents to become comfortable with and proficient in robotic surgery.”
Kim’s revisions to the gynecologic resident training gave residents one-on-one training sessions with him on a quarterly basis. Through this, he was able to track data over a year’s time and quantifiably show that, with individualized attention, his residents’ skillsets improved tremendously – enough to convince Intuitive Surgical, the maker of the da Vinci Surgical System, to provide UAB with its own robotic surgery simulator with updated and exclusive simulation software that will be used to train residents across multiple surgical disciplines.
With a shared mindset that resident education needed to have a strong focus on robotic surgery training, surgeons across many fields are working together toward a common goal of advancing curriculum for residents of all years and specialties.
“We pride ourselves on being early adopters and innovators, and knew it was critical to change the theory that robotic surgery should be used exclusively by chief surgeons,” said John Porterfield, M.D., associate professor and director of UAB’s General Surgery Residency Program. “We wanted to give our residents the tools and time to familiarize themselves with the robot and training as often as possible, which has set UAB’s residents apart nationwide in terms of comfort and skill in robotic surgery specific to their fields. We have been able to prove that the extra attention our residents are given has helped UAB lead the way in a responsible manner that ultimately benefits our patients and the quality of care they receive.”
Porterfield also attributes UAB’s success in reaching the 10,000 robotic surgery milestone to the joint relationship between surgeons and hospital administrators.
“We have found a great balance where surgeons and hospital administrators have mutual understandings about each other’s interests so that, ultimately, our patients are the ones who benefit most at the end of the day,” Porterfield said. “The ‘rising tide floats all boats’ mindset has enabled all involved with robotic surgery to leave a legacy and frame groundwork that will continue to leverage UAB’s innovative offerings to patients on a local to international scale.”
UAB surgeons say they feel a particular responsibility to continue to serve as leaders in the field. Knowing that ongoing research, technological advances and collaborating are keys to success, Nix says working together to meet quantifiable goals and training the next wave of surgeons at the highest level will continue to give UAB a competitive edge.
“At the end of the day, we are committed to increasing surgery volumes while simultaneously increasing positive patient outcomes,” Nix said. “We are confident that our continued successes will keep UAB’s name synonymous with top robotic surgery care, and hope that we can continue to lead by example in our next 10,000 surgeries.”