CEL surgery and Mako Robot make their debuts at HSHS St. Joseph’s Hospital

By ALAN J. ORTBALS
    HSHS St. Joseph’s Hospital Highland has upgraded its surgical capabilities by adding a new procedure and new robotic technology.
    The new procedure is known as CEL (Combined Endoscopic and Laparoscopic) and it’s used for the removal of certain colonic tumors. The CEL procedure is performed by a team of physicians that includes Dr. Peter Kim, gastroenterologist, and general surgeons Dr. Joshua Knolhoff and Dr. Jose Diaz. The physicians performed the first CEL procedure at St. Joseph’s Hospital on July 6.
    Patients who qualify for the CEL procedure are those with a tumor that cannot safely be removed due to its location, position or a high risk of perforation to the colon. Patients who have flat tumors that are harder to reach are also candidates for the procedure. In these cases, removal of the tumor through the CEL procedure is an alternative option to a bowel resection.
    Patients who require the removal of a colonic tumor through a traditional colon resection are subject to a lot of pain and a recovery time that can last up to a week in the hospital. The new CEL procedure reduces the amount of pain associated with the removal and allows a patient to potentially go home the same day.
    “Prior to the development of this procedure, when patients had colonoscopies and a polyp was found but it was not possible to remove it with the scope, the patient would have to be scheduled for a bowel resection where a small section of your bowel is removed,” explained Julie Obermark, director of surgical services at St. Joseph’s. “With this new CEL procedure, the gastroenterologist and a general surgeon work together to remove the polyp through a scope. Instead of a large incision in your stomach, you have three or four little half-inch incisions more like you would have with the laparoscopic gallbladder procedure.”
    “The benefits of this procedure for a patient is less pain, faster recovery, and the ability to immediately manage any complications that arise, since we have a team of physicians involved,” added Kim. “This is a pretty progressive procedure and we are very excited to be able to offer it in Highland.”
    At the end of August, HSHS St. Joseph’s Hospital Highland announced the arrival of its newest technology – the MAKO Robot. The MAKO Robot will be used for partial knee replacement and total hip replacement surgeries, called a MAKOplasty. The MAKO Robot allows for faster recovery and longer lasting results for patients.
    “We are very excited to bring the MAKO Robot to St. Joseph’s Hospital,” said Elizabeth Govero, chief nursing officer at St. Joseph’s Hospital. “This technology will help us enhance the care we provide to our patients and allow them to receive this type of advanced procedure close to home.”
    Surgeries using the MAKO Robot offer many benefits over traditional knee or hip replacement procedures. Many patients experience reduced pain, minimal hospitalization, more rapid recovery, less implant wear and loosening, a smaller scar and better motion.
    The MAKO Robot assists the highly trained physicians who use the technology to achieve a new level of reproducible precision during the surgery. Prior to the surgery, patients have a CT scan of their joints to create a personalized 3D model of their unique anatomy. That model is loaded into the MAKO system where an individualized pre-operative plan is set. During surgery, the MAKO helps guide the surgeon within the pre-defined area mapped out from the model with established boundaries. By having this pre-determined area, the MAKO helps provide more accurate placement and alignment of the implant.  
    “This technology allows us to create a completely personalized plan for patients,” said Dr. Felix Ungacta, orthopedic surgeon at St. Joseph’s Hospital. “We are able to create an implant treatment plan designed specifically for each patient. The MAKO then increases the accuracy of placement and positioning, allowing for all-around better outcomes for our patients.”
    “The doctor is guiding the robot the whole time,” added Obermark. “But the MAKO Robot is so precise, it can take the definition of your knee down to within one millimeter of your actual knee so the implants are customized for each patient. It cuts down recovery room time, cuts down your pain and improves your range of motion. It’s a great procedure. We are very excited about it.”