In the Detroit Metropolitan Area several hospitals took the initiative and have the expertise to use those methods comprehensively on. 

One of the most interesting examples in this approach is Beaumont Hospital with facilities in Royal Oak, Troy and Grosse Pointe, Michigan.

Beaumont Hospital takes advantage of the newest generation of surgical robots, neuronavigation and intra-operative monitoring devices. Robot utilization during surgery results in surgical procedures performed with higher precision. Robots, under the supervision of highly specialized surgeons, are equipped with software minimizing human error. Robot’s software can, for example, calculate the position of a surgeon’s hand and eliminate even the smallest vibration of the hand. The surgeon has the ability to conduct surgeries remotely. 

A new technology, called neuronavigation is often used. This technology is similar in principle to well known GPS. Surgeons may triangulate the exact location of a tumor and remove it without causing damage to surrounding structures. Patients where neuronavigation has been used report less postoperative deficits or trauma and recovery is faster.  

Intraopertive monitoring technology has been around for years but only recently has matured into a powerful method and became an integral part of the operating room. This method used during the procedure eliminates the risk of nerve damage. According to estimates 3,000,000 examples of nerve damage are reported resulting from a variety of causes and medical errors.

Nerve damage can take the form of sensory deficit in a finger, loss of muscle control or total body paralysis in extreme cases. 

Utilization of neuromonitoring allows the surgeon to conduct the procedure with less stress and with higher mental control, influencing the surgical outcome and reducing the risk to a patient. An intraoperative monitoring device has the operational capacity to perform several monitoring tests at the same time. Electroencephalography, sensory nerve routes, motor routes and muscle activity monitoring (EMG) can also be used in polysomnography and nerve conduction studies.

Beaumont Hospital in Royal Oak maintains and operates the highly sophisticated Marcia & Eugene Applebaum Surgical Learning Center located inside the hospital.

It is very unique, equipped with a virtual operating room with artificial patients. It utilizes software that can simulate a variety of medical conditions and body reactions. Young surgeons can perform procedures without putting real patients at risk. The center operates surgical robots, laparoscopic simulators and a multimedia center, open in physical and virtual form to specialists regardless of their location in the world.

Two weeks ago, Beaumont Hospital hosted a guest from Poland, Dr. Henryk Szczerba M.D., Ph.D, general surgeon, Director of the Hospital Network in the Silesia region in Poland.

Dr.Szczreba has been hosted by Dr. Robert P. Jury, M.D., a general surgeon and Strategic Planning & Program Development Director at Beaumont Hospital.

Doctor Jury is considered “the best around” for Whipple procedure to treat tumors on the head of the pancreas, the common bile tract and the duodenum near the pancreas. Pancreatic tumors are deadly because if not discovered before thay spread time to cure is usually very short. 

It requires not only fast action but also tremendous expertise by the surgeon. The best hospitals and the best surgeons that perform this procedure frequently have mortality rates four times lower than other hospitals. His peers at Beaumont and elsewhere hold Dr.Jury in very high regard. He performs dozens of Whipple procedures every year and is considered a surgeon who has pretty much seen it all.

Dr. Szczerba was able to observe procedures done by Dr. Robert Jury and also an endovasular procedure performed by Polish vascular surgeon Dr. Maciej Uzieblo, M.D.

Dr. Szczerba also had the opportunity to observe a surgery with the use of the sophisticated, four arms DaVinci surgical robot. After concluding surgical procedures, the doctor from Poland was been hosted by doctor James Robbins, M.D., the Chief of the Marcia & Eugene Applebaum Surgical Learning Center. Dr.Szczerba had the opportunity to utilize the surgical robot in making sutures on artificial tissue. 

The Marcia & Eugene Applebaum Surgical Learning Center at Beaumont Hospital is a place that makes a big impression on anyone. Doctor James Robbins, M.D., the Medical Director of the Center is a very enthusiastic person who explained with passion the extensive abilities of the center. According to Dr. Robbins and his employees, with banks of data in patient’s servers, even the people who know the center’s equipment the best are still learning every day they use it.  The ability to observe the complex at Beaumont creates the impression of a contemporary medical center truly providing the patient with the best treatment, best surgical options and best outcome resulting from taking advantage of the newest, most sophisticated surgical methods and developments in the country. 

During the second part of his visit, Dr. Szczerba met with the director of the Larry Head Neurodiagnostic Institute - Larry Head - to observe and assess the effectiveness of intra operative monitoring methods. Mr. Head is a well-known pioneer and distinguished educator in the filed of intra operative monitoring.

 Prior to his departure I asked dr.Szczerba to sum up his impressions from the trip.

-By now, Dr. Szczerba, you probably are able to provide some comparison of medicine and procedures in the U.S. and Poland. Could you share with our readers some of your observations?

-Dr. Szczerba – Medicine in Poland and professional skills of Polish doctors are high, comparable to their American colleagues. The major difference, most likely, lies in the amount of money available to Polish hospital networks.

-Your first impressions?

- I think that people in Poland would have difficulty imagining how and on what level American hospitals operate. The immensity, complexity of hospitals such as Beaumont Hospital, the number of specializations they offer is truly impressive. I am positive that as a result of this visit I will be able to offer some valuable suggestions to my colleagues in Poland.

- Did you find something in particular that caught your attention?

- Order, discipline and organization of labor. Furthermore, attention to costs and the large number of procedures performed. Each employee is busy and concentrated on the job. At Beaumont Hospital my attention has been attracted by the Emergency Room. A patient during admission, already at the door, has at his disposal the newest techniques, methods and equipment. In the E.R. everything is already collected in one place, next to the bed, and ready for the patient. Equipment is not distributed incoherently all over the place. This is extremely important, especially in cases that require immediate attention, where truly, every second could make the difference. Impressive, really.

- Could you compare the relation of doctor with the patient in Poland and in USA?

- That’s true. The contact of doctors with patients is different. Here, doctors have a positive attitude towards the patients, they smile. This is an important physical comfort for a suffering person. In Poland contact with patients is dry, machinelike. Here in the US, friendly. In Poland, polite but formal.

- Did you see any particular medical procedure or medical equipment that could, if implemented, bring a measurable help for patients in Poland?         

- One of the goals of my visit is assessment of usefulness of intra operative monitoring equipment. This technology in Poland is still very sparse. It is not expensive and its presence in the operating room can bring the patient a measurable advantage. This technology positively impacts surgeon’s comfort level and decreases his stress.  As a result the risk of postoperative complications or deficits is smaller.

-What is this method all about?

- The method has application where nerve structure is at risk, especially during neurosurgical procedures such as scoliosis. Nerve damage is a real danger to the patient.  Intra operative monitoring during the procedure can eliminate many negative outcomes of nerve damage or even total body paralysis in extreme cases. That’s the first technology I would like to see more of in Poland. During the visit I was able to participate in a three-day introductory course in intra operative monitoring. I met Larry Head, a nationally known instructor and director of a neurodiagnostic institute that specializes in teaching all neurodiagnostic procedures. I have invited Mr. Head along with his staff to Poland to create a school for neurodiagnostic technologists.

- The invitation has been accepted? And in what language would the classes be conducted?

-Yes, it has been accepted. Basically we have to work out the logistics and as far as language, the courses will be taught in English. This language no longer presents a communication barrier.

-This was your first visit to the USA?

- Third. The goal of the first two was participation in medical rescue team championships. The team under my leadership traditionally competes for first place with the American team. Three years ago, in China, the Polish team won first place; two years ago we lost only to the American team. Next year we will try to recover our first place during championships in Canada.     

- Would you say that this visit was productive?

 - Certainly, I hope that the biggest beneficiaries of this visit will be patients in Poland.

- Thank you for the conversation and we wish you good luck.

- Thank you. I also would like to thank my American colleagues at Beaumont Hospital, dr. Robert P. Jury, M.D., Dr. James Robbins M.D. and Dr. Matt Uzieblo M.D. for taking their valuable time and sharing their passion with me.

Gregory Lukasik spoke with Dr. Henryk Szczerba.

If you are interested in a career in intra operative monitoring, nerve conduction study please contact Gregory Lukasik at Larry Head Neuroscience Institute

at 248 330 3520

or EquusAstra @ AOL.com