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Dr. Jay Redan serves as chief of surgery at AdventHealth Celebration. Throughout his 30+ years of experience, he has witnessed the dramatic evolution of surgery from open procedures to minimally invasive robotics. Dr. Redan shares the impact and advancements of digital technologies, such as transformative pre-op planning and post-operative video-based assessment products, to help improve patient care.
AS A DISTINGUISHED LEADER AND SURGEON, HOW HAVE YOU SEEN SURGERY EVOLVE WITH THE INTRODUCTION OF DIGITAL TECHNOLOGIES?
I see the way we learn, share, and teach changing. Surgical education used to be when we had our residency and fellows train one on one. We then had the ability, with laparoscopic surgery, to video record our procedure. Then we would make DVDs to share with each other. However, now with a HITRUST CSF® Certified digital platform, which complies with applicable privacy laws, including HIPAA, HITRUST and GDPR, we can securely share recordings of our procedures with each other digitally. We can grade our videos with well-defined metrics on how we move the camera, how our hand eye coordination is doing, and how our assistant helps us in surgery, giving us defined learning moments through recorded cases. We can measure our improvements, taking surgeons of all different levels and skills, to bring everyone up to an equal level where we are all providing excellent care of our patients.
WHAT SURGICAL CHALLENGES OR NEEDS DO YOU SEE PRE-OPERATIVE PLANNING HELPING YOU ADDRESS IN PROVIDING EVEN BETTER PATIENT OUTCOMES?
Pre-operative planning is key to the success of an operation. Digital technologies can help surgeons rehearse the procedure ahead of time with the surgical team, especially if we have a potentially difficult case. People like to go over the possible areas of the operation where we may experience challenges – maybe there's a tumor that is close to a vital vascular structure. We must plan for possible interoperative, vascular reconstruction. When a tumor or inflammatory process is near ureters, we want to make sure we have the appropriate team members such as urologists nearby so we can rehearse and discuss these potential areas of challenges during surgery. Through careful pre-op planning, even for the most “simple cases”, we can minimize interoperative problems and surgical errors.
WHAT DO YOU FIND TO BE THE MOST VALUABLE ASPECT OR BENEFITS FOR INTEGRATED POST-OPERATIVE VIDEO-BASED ASSESSMENTS?
Currently we use C-SATS to review our videos of operations completed by the surgeon, the assistant, and the team. We deconstruct these videos into certain parts of the operation – say doing a hiatal hernia repair and division of short gastric vessels, isolating the esophagus, proper identification of vagus nerves, calibrating the anti-reflux wrap appropriately, closing the hiatal hernia defects appropriately, assessing for tension on your repair, just to name a few examples. Many times, during your surgical procedure you don't realize what you did until you review the video. I see zero reason why we can't videotape surgeons to review their skills, give them feedback, increase their proficiency and awareness in certain surgical situations and continually measure their progress in a video-based, analytic way. I think it's just common sense – everyone should be doing this.
HOW HAS BEING AN EXPERT REVIEWER ON THE C-SATS PRODUCT INFLUENCED YOUR DAY-TO-DAY SURGICAL EXPERIENCE?
It’s always a benefit to the reviewer. We always see things that we might not have thought of before. We learn new tips and tricks ourselves. I've reviewed videos, seen other ways to do a procedure, and learned new techniques. So even as the reviewer, there's always room for improvement. There's always a way for the reviewers to be educated as well as share their knowledge and experience with the reviewees. It's a continuous dialogue amongst reviewers and reviewees, and that's how we all make ourselves better, by working together.
WHAT IS YOUR ADVICE TO SURGEONS FOR ADOPTING NEW TECHNOLOGY FOR THE FUTURE OF SURGICAL HEALTHCARE?
We need the comprehensive care of our patients – pre-op, intra-op, post-op – matched with our outcomes and then to adjust that by comparing what you do, and your colleagues do, so we can get a standardization of the procedure, to do every procedure equally, no matter what the surgeon’s tenure, making us all great surgeons. Again, the best way to do that is recording your videos, sharing your metrics, understanding what you do, good or otherwise, bringing the cost down, bringing the quality up. This is the way we are going to go in the future.
This article reflects the opinions of Dr. Jay Redan.
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