Quality

Hospital portrait
Shonan Fujisawa Tokushukai
Hospital was reopened afterreconstruction in October 2012as a key clinical institute in thisregion. A hybrid OR dedicatedfor the spine and scoliosis
center was set up and equippedwith the Artis zeego robotic
imaging system, the TruSystem
7500 operating table, and the
CURVE navigation system(BrainLab). It is the first installation dedicated solely for
spinal surgery worldwide, andit plays a pioneering role inorthopedic surgery in Japan.

Dedicated forspinal surgery onlyDr. Sohei Ebara, vice president of the Shonan
Fujisawa Tokushukai Hospital and director of
the spine and scoliosis center, is a pioneer indeveloping safer, less invasive image-guided
procedures for spine surgery.
From 2004 to 2014, Dr. Sohei Ebara performed 2,330 spine surgeries, including cervical, thoracic and lumbar spine, and scoliosis surgeries. But 2012 wasa game changer: After his long experience with the use of mobile C-arms,
Dr. Ebara built a hybrid operating room dedicated solely for spinal surgery.
The Artis zeego robotic imaging system allows a smoother workflow during
the procedure.
The effect: operation time shortened by almost half. And he was able to nearly
double the number of procedures from 463 in 2011/12 to 768 in 2013/14 – anincrease of 66% in only two years! But to Dr. Ebara, the most important aspectis the superior clinical outcome in the hybrid operating room compared with theprocedures performed in a conventional operating room.

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What effect did the introduction ofArtis zeego have on your workflow?
S. EBARA: Initially, it took us eight
hours or more for scoliosis surgery
with endoscope. Now, since we implemented zeego, it takes only four hours.
The reason: In the past, we needed
to turn the body two times to scan inendoscopic scoliosis surgery (anteriorapproach) and three to four times toscan in open scoliosis surgery (posterior approach). But with zeego, it ispossible to do 3D images from ilium
to thoracic vertebra No. 6 or 7 by twoturns. In the past, we could handle
only one scoliosis surgery per day. But
the duration of the surgery is crucial:
Four or eight hours makes a big difference. And when the surgery is finishedin three to four hours, we can evenperform one more surgery per day!
How did you convince the management that the investment will really
pay off?
S. EBARA: We emphasized the advantages of zeego. Our system was theworld’s first system specialized forspine – great for public relations! We
realized that even if the system is used“From 5,041 screws
implanted, only
nine screws had tobe reinserted, whichmeans an ultralow
complication rateof only 0.18%.”

A complication rate of less than 0.2%
is an amazing result. How is thatpossible?

S. EBARA: With the metal artifacts
from the implants, usually image
quality declines. But with zeego, theimage is clear so that we can quickly
make an accurate and smooth decision. That reduces stress to the surgeons and increases patient safety.
zeego memorizes the system position
so that we can immediately scan withintraoperative DynaCT. In the anteriorscoliosis surgery, there is the aorta at
the other side of the vertebral body.
If it is low back, there are great vessels. The screw needs to be carefullysolely for the spine surgeries, it canpay off. With zeego, the stress for the penetrated through the bone cortex
surgeon is dramatically reduced. And into the other side, but it should not
we could also reduce the complication touch the great vessels by pushing it
too much. To fix the screw right, werate: From 5,041 screws implanted,
only nine screws had to be reinserted, can use DynaCT to precisely control
it. The image is very accurate: That
which means an ultralow complicamakes us confident.
tion rate of only 0.18%. We haven’thad a lawsuit for the last ten years,
and in that respect the system is supporting the hospital management.
And last but not least: Our staff andpatient dose level is decreasing. All
these facts explained pretty well why
we should invest in the technology.

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