Dr Deric De Wit, Ophthalmologist (Front) & Tamara staff
(Debra McClenahan, Juan Carlos Fernandez, Leanne
Rushbrook).
The Ramsay Way 2018 | 01 9
HOSPITAL NEWS
Tamara Hospital in
Tamworth offers
ground breaking
glaucoma surgery
St George Private- Australia’s first
Mobile Integrated Theatre System
St George Private has taken delivery of Australia’s first mobile integrated theatre system called the NuCART.
The NuCART system is an all-in-one Mobile Video Integration and Boom System. It features an inbuilt integration system, which can
connect and display multiple surgical images from a variety of image sources simultaneously. This can all be controlled with the easy to
use wireless tablet.
It replaces some of the traditional built-in integrated theatre infrastructure, with its large shelves for surgical equipment and its far-reaching
dual arms with surgical monitors. The NuCART’s arms can be folded in moments, and because it is on wheels the whole
system egressed through a standard sized door, making it as portable as a traditional imaging stack.
WOLLONGONG
PRIVATE HOSPITAL
LAUNCHES ACUTE
PAIN SERVICE
Wollongong Private Hospital is now offering an
Acute Pain Service (APS) to orthopaedic patients.
Staffed by specialist anaesthetists and a designated
pain nurse, the APS focuses on optimising pain
management after major surgery, enabling patients
to commence earlier and more comfortable
mobilisation.
The service offers advanced pain reliving techniques including
the insertion of nerve catheters to deliver local anaesthetic
directly to the nerve, preventing the transmission of pain signals
to the brain. This also reduces the need for strong opiates,
minimising side effects such as drowsiness, constipation and
nausea which will delay recovery.
Q&A WITH DR GERARD
TESTA, ST GEORGE PRIVATE
UROLOGIST:
What is the most appealing feature of the NuCART
system to you?
The NuCART system allows the surgeon to maximally utilise the
digital information from all input sources such as endoscopy,
X-Ray and Ultrasound whose images can then be manipulated
easily to produce a detailed and highly professional record of
the patient's procedure. In conjunction with the Medicap system
incorporating pre-populated fields that can be user defined,
allowing for accurate unambiguous records which can then be
used to inform not only the surgeon but patient, recovery and
ward staff and referring doctors.
Has the NuCART provided an increase in theatre
operative efficiency?
The NuCART allows for multiple screens which are easily
manipulated so as to provide a comfortable operator view angle
also decreasing the clutter of having multiple apparatus with
their individual viewing screens, which because of bulk often
mean obstructed or uncomfortable viewing. The multiplicity of
cords to separate apparatus (that are usually haphazardly strewn
on the floor) also provides for safety concerns to the surgeon
and staff in theatre. The NuCART system allows for a safer
environment as the cords feed into the one unit allowing for a
clutter free theatre.
In the Urological speciality there is often a combination
of imaging devices required to perform a procedure
(Rigid cystoscope, C-Arm, Ultrasound and flex scopes).
Have you found it advantageous to be able to integrate
these different devices and display them on a screen of
your choosing?
The ability to manipulate not only the position of the screen
but what is displayed on the screen allows for more easier
manipulation of endoscopic equipment. This is particularly
important during long cases such as ureterorenoscopic stone
surgery. It was not uncommon after lasering a stone for a
prolonged period of time to have neck and shoulder discomfort
due to looking at different screens which were situated at less
than ideal positions due to competing equipment placement.
The ability to split a screen to show two images or change
the image on one screen between X-ray and endoscopy is a
tremendous step forward both for surgeon comfort and
patient safety.
Thanks to the support of the management
at Tamara Hospital in Tamworth, ab-externo
viscocanaloplasty surgeries have successfully
been offered by Dr Deric De Wit and team since
late 2016.
Viscocanaloplasty is an advanced non-penetrating
glaucoma surgery which is new to Australia and is ideally
suited to a rural population suffering from moderate to
advanced glaucoma. Ellex, an Australian based company
which produces the advanced iTrack microcatheter and
iLumen laser diode device, makes the procedure possible.
It has been performed over 60,000 times worldwide
with excellent uptake in Germany, the USA and recently
China - swifty becoming one of the leading glaucoma
procedures for both clinician and patient alike. It was
recently awarded the German Federate Eye Association
(Bundesverband Auge) patient advocacy groups highest
endorsement as the 'Gold Standard' in the surgical
managment of glaucoma.
The intraocular pressure lowering effect is greater than
current minimally invasive glaucoma surgeries (MIGS)
and it is a non-penetrating eye procedure (often coined
'angioplasty of the eye' ) with faster recovery and
significant less morbidity than the current penetrating
trabeculectomy operation.
"The support for myself and my highly skilled team
have been excellent and on behalf of the patients who
have benefited from this procedure locally I would like
to extend my thanks and gratitude to Darren Ninness,
CEO of Tamara for his insight and support in bringing this
procedure to fruition" says Dr Deric De Wit FRANZCO
FRCOPHTH who performs the procedure.
"A special thanks goes to the surgical team led by
Debbie Mclenahan who have distinguished themselves
through their dedication in perfecting the support for
this challenging procedure''. Dr de Wits encouraging 12
month results with this procedure are due for publishing
in 2018. "There is a barrier to widespread adoption of the
technique as it takes significant surgical learning time
to have sustained and consistent results. I am hoping to
see this procedure become the new gold standard for
glaucoma surgery in Australia and am actively working
towards simplifying it with fellow researchers at Ellex for
greater uptake in the surgical community".