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The science side of the healing arts

Local hospitals are Making the most of advances in healthcare tech.

By Lisa Allen

Tender, loving care is the best medicine around, but sometimes we need a little more than that. Here in the Lowcountry we get both: The best of technology and science and some of the nicest healthcare providers anywhere. On Hilton Head Island and in Bluffton, we have Hilton Head Regional Healthcare. To the north, we have Beaufort Memorial Hospital. South, we have St. Joseph’s/Candler. In all directions, you’ll find technologies that offer gentle ways to help us lead healthier lives.

When knees start showing their age

As we get older, our parts start to show that wear, often in the form of osteoarthritis or degenerative joint disease. When anti-inflammatory medication and cortisone no longer work, it’s time for the next step, pardon the pun.

“If the pain begins limiting even simple activities, such as climbing stairs, shopping or gardening, it may be time for total knee replacement surgery,” said board-certified orthopaedic surgeon Dr. Edward Blocker, chairman of Beaufort Memorial’s orthopaedic department.

Using the Mako Robotic Arm-Assisted Surgery System, the diseased joint is replaced with an artificial joint or implant designed to move much like your healthy joint, not just some generic, one-size-fits-all solution.

The surgical system’s software creates a 3-D model of your knee and helps the surgeon develop a pre-operative plan specific to you. The surgeon uses the model to evaluate bone structure, disease severity, joint alignment and the surrounding bone and tissue to determine the optimal size, placement and alignment of the implant.

“We can see the knee on a computer screen and decide the size and position of the implant that would work best,” Blocker said. “With the robotic arm, we can implant the components with greater precision, which can increase their longevity.”

Dr. Edward Blocker discusses knee surgery options with a patient. Blocker is one of several Beaufort Memorial orthopaedic surgeons currently using the Mako robot-assisted knee replacement technology.

In the operating room, the surgeon guides the robotic instrument arm to remove only the diseased bone, preserving the healthy bone and ligaments around it. Virtual boundaries established by the robot prevent the surgeon from irritating surrounding soft tissue.

Once the arthritic bone and cartilage are removed, the surgeon implants the total knee components into position.

“We can move the knee through a range of motion and see it on the computer screen,” Blocker said. “It allows us to objectively measure the tension of the ligaments to precisely balance the knee to that patient’s unique anatomy.”

A properly balanced knee feels more natural and functions better, which can extend the life of the implant, Blocker said.

Going gently under the knife

St. Joseph’s/Candler has upgraded its robotic technology, adding da Vinci Xi, the fourth generation. The system gives surgeons magnified views of regular laparoscopic surgery while retaining the three-dimensional view of traditional open surgery, all in high definition.

For patients, this means less pain, less blood loss, a shorter hospital stay and a quicker recovery.

The da Vinci Xi Surgical System is used either bedside or from above, allowing surgeons to use the best approach.

“The robot is the system of instruments, and I control the instruments,” said general surgeon T. Ellis  Barnes IV, MD. “I’m a perfectionist, so the degree of articulation afforded to me by the wristed instrument is phenomenal. The visualization is amazing, and it’s all 3D. One of the basic surgical principles is to have as little tissue damage as possible.” The da Vinci’s gentle touch allows just that.

Fighting breast cancer

First, BMH offered 3D mammograms, now it’s added an advanced ultrasound technology that helps doctors find cancers hidden in dense breast tissue. Invenia Automated Breast Ultrasound System (ABUS) is used alongside annual 3D mammograms.

“Mammography is the gold standard for detection of breast cancer, but it doesn’t work equally well in all women, particularly those with dense breast tissue,” said Dr. Phillip Blalock, chief of radiology at Beaufort Memorial Hospital. “The ABUS screening improves breast cancer detection and is another tool we can use to give women with dense breasts peace of mind.”

Some 40 percent of women in the U.S have dense breasts, which means they have a greater amount of connective and fibrous breast tissue than fat in their breasts. While it is a common condition, women with dense breasts are four to six times more likely to develop breast cancer. A mammogram alone may not be enough to detect breast cancer in its early stages.

Unlike 2D or 3D mammograms, which use radiation to create an X-ray image, ABUS uses sound waves to provide 3D pictures of the breast tissue. On a mammogram, dense tissue and masses both appear white, so a suspicious lump may be hidden in dense tissue. When dense tissue is scanned with ultrasound, the tissue appears white and masses appear black, making them easier to see.

Cancer services right where you need them

Leading-edge cancer treatment is now easier to access in both Beaufort and Okatie. Beaufort Memorial Hospital, in partnership with MUSC Health and Alliance Oncology, now boasts two state-of-the-art cancer centers in the area.

Last year the hospital consolidated its cancer services in Beaufort to its main campus and more recently, opened the New River Cancer Center at the Okatie Medical Pavilion. Putting both core and ancillary cancer services in the same locations enhances the multidisciplinary model that has shown to improve outcomes.

Beaufort Memorial radiation oncology Dr. Jonathan Briggs treats patients using the Varian TrueBeam linear accelerator at the Keyserling Cancer Center in Beaufort. Thanks to its partnership with MUSC Health and Alliance Oncology, Beaufort Memorial is able to offer state-of-the-art radiation therapy treatment in both Okatie and Beaufort.

The hospital’s affiliation with the National Cancer Institute-designated Hollings Cancer Center at MUSC allows BMH patients to participate in groundbreaking clinical trials studying promising new cancer drugs and treatments and provides access to MUSC subspecialists experienced in treating rare and complex cancers.

And thanks to the Alliance Oncology partnership, patients can benefit from the newest radiation oncology systems, which target tumors with pinpoint precision while providing a treatment environment more comfortable for the patient.

“We’re offering the same advanced technology and protocols available at leading cancer centers,” said Jonathan Briggs, M.D., medical director of Radiation Oncology Services at the Keyserling Cancer Center in Beaufort. “It makes it so much easier for patients when they can receive their treatment close to home.”

Better open MRIs

Once upon a time, doctors had to choose between sharp images from a traditional MRI or less crisp images from open MRIs. That was then. The Oasis High-Field Open Magnetic Resonance Imaging System at St. Joseph’s/Candler Imaging Center in Bluffton has a 1.2T superconducting magnet, the highest field strength in existence for an open MRI.

MRI technologist Shannon Morris is shown next to the new Oasis High-Field Open Magnetic Resonance Imaging System at St. Joseph’s/Candler Imaging Center in Bluffton.

Traditional MRIs create detailed images of a patient’s anatomy without exposure to radiation. But even though it’s a non-invasive scan, the tubular machine itself can be uncomfortable — and sometimes unbearable — for larger patients, for children who don’t want to be alone, and for those who fear enclosed spaces. For claustrophobic patients, the open architecture provides a 270-degree unobstructed view. For larger patients, the space is designed to provide comfort in any position and has a 660-pound weight limit. For children, a parent can be right beside the child for the entire scan.

Taking 3D mammograms on the road

One of the major barriers for women to get their annual mammography screening is time, especially for those who live or work far from a hospital. No worries. St. Joseph’s/Candler’s Mobile Mammography Unit will come to you, now with tomosynthesis, or 3D mammography.

“Tomosynthesis is very helpful in certain populations, particularly women with more dense breast tissue,” said Lora Reese, director of Telfair Ambulatory Services. “It captures fifteen different images of the breast, offering much more information than one 2D image. The 3D technology also decreases the need for many patients to be recalled for additional imaging.”

And TLC too

St. Joseph’s/Candler has built up quite the team to help people navigate the stressful journey through cancer. “The Bluffton campus is tailored around the patient experience,” said Pam Proman, director of operations and strategic initiatives for the Lewis Cancer & Research Pavilion. Patients can enlist the help of a patient navigator, financial navigator, social workers and dietitians.

New chemo chairs aren’t just comfortable—they are heated, can easily be adjusted electronically and include a space for your belongings. Previously, patients may have held their purses or bags in their laps for hours.  It’s the little things, the TLC, that helps us heal.