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Douglas Merrill, MD, medical director of the new UI Ambulatory Surgery Center, talks about the new ambulatory surgery center:
How is an ambulatory surgery center different from any other surgery center?
Ambulatory surgery centers, or outpatient surgery centers as they’re commonly referred to, are sites that typically are separated from a hospital. They also can be attached, as we’re fortunate enough to have here.
They were begun with some visionary folks back in the early 1970s who recognized that healthy people undergoing particular kinds of procedures would do well going home to be cared for after surgery rather than requiring the expensive, in-hospital stay.
Surgery centers are designed to take care of relatively healthy patients having procedures that, as each year goes by, become more and more invasive. Surgery center procedures can in fact leave patients feeling well enough that they can go home and be cared for by family rather than by health care workers.
When did the UI Ambulatory Surgery Center officially open?
The new Ambulatory Surgery Center here at the south end of the hospital campus opened March 26 with two rooms, and then we slowly ramped up and are now at a capacity of six rooms.
How are the operating rooms set up for teaching purposes?
The operating rooms are uniquely designed to aid with teaching. To begin with, a patient who comes in the operating room here will notice that the operating rooms themselves are extremely large, so they can hold a fair number of students and surgeons-in-training.
Even more interesting is the use of Stryker technology. Stryker is a company that is involved with operating room management. We have cameras in the overhead lights, and cameras in various locations around the room connected to a video system that can beam the image 40 or 50 feet down our hallway to a classroom, where residents-in-training, students, can watch what’s going on in the operative field.
This technology also allows us to beam the image long distances. So, for instance, if a patient comes from fairly far away from Iowa City, their referring physician, their family doctor, could actually be hooked up via an Internet, see the visual image on the computer and be able to follow along the surgery that’s being performed, even though they might be hundreds or even thousands of miles away.
How does a pediatric same-day surgery differ from adult same-day surgery?
With pediatric same-day surgery, we do:
- Ear, nose, and throat surgeries such as ear tubes or tonsils and adenoids.
- Ophthalmologic surgery with children who have eye muscle disorders.
- Urologic surgery
Children differ from adults significantly with regard to surgery in the sense that they sometimes have the same high anxiety our adult patients do, but we, of course, can’t use rational logic to take care of that. We have many techniques and we have a superb group of pediatric anesthesiologists who work very well with both pediatric patients and their parents to reassure them and make it a pleasant experience in terms of going to sleep. Then, using some very high tech and frontier-breaking technology, we’re able to, in many cases, use local anesthetics in artful ways to make patients very comfortable afterwards.
This is of course true for both children and adults, but it’s very important for children because it helps them wake up feeling good and much less distressed. So with children, especially the younger children, patience is at the core. I have been very impressed since I arrived here just a couple months ago, that our anesthesia staff is extremely good in this regard.
Are all areas and operating rooms open, or are they opening in stages?
We started with two rooms, worked through four rooms for three weeks, and now we’re at our current capacity of six rooms fully open and operational. The Surgery Center was beautifully designed, as patients and families will see as they come here, and one of the great aspects of it is that a seventh and eighth operating room are available so that in the future, if we reach capacity and are having significant patient waits to get in, then we can open those rooms and do so fairly rapidly.
When a center like the UI Ambulatory Surgery Center is operating at maximum capacity, how may same day surgical procedures will there be on a typical day?
It’s really variable in the sense that some surgical procedures are as short as seven to eight minutes and some will take two to three hours. But I think, in general, if we had eight operating rooms functioning fully, that we would typically be somewhere between 40 and 60 operations a day.
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