Par
Julien Van Caeyseele
Published on September 3, 2024 at 5:00 p.m. See my news Follow La République de Seine et Marne
In 2023, some 7 731 interventions were carried out in the surgical department of the Fontainebleau hospital (Seine-et-Marne), an increase of 16.1% compared to 2022. And the hospital center intends to continue this growth, thanks to the implementation of new features within the establishment. For nearly three years, this site of the South Seine-et-Marne Hospital Center (CHSud 77) has a surgical robot and will develop its uses.
New developments in the surgical department of Fontainebleau hospital
“It’s a technique that is much less invasive and allows for more complex procedures,” explains Dr. Dine Koriche, a visceral surgeon at CHSud77Until now, this technological tool was used in urology and gynecology, but it is now used for other interventions, particularly in visceral surgery.
“For example, we can use it for cases of colon cancer, or to treat hernias, gall bladders or liver surgery,” lists the surgeon. “This robot opens up the field of possibilities: it is the future of surgery.”
In addition to the use of the robot, the surgery department of the Bellifontain hospital also offers new developments concerning specific pathologies. This is the case, for example, in the management of sinus pilonidalan ingrown hair which causes a superinfection, at the level of the intergluteal cleft.
New support for patients
Since the beginning of the summer, new support has been offered to surgical patients at the Fontainebleau hospital. Designed by the teams of operating room nurses and anesthetist nurses, this Perioperative Somato-Emotional Support Project (Paspor) helps reduce stress, pain and anxiety, but also reduces the use of medication. In addition to an operation, several techniques are offered to support patients: from hypnosis to sophrology (yoga, relaxation, meditation, etc.) through shiatsu, massages or even the use of virtual reality headsets or audio headphones. “It is personalized care for the patient,” explains CHSud77.
“It’s a very common pathology, but very painful,” explains the doctor. “Until now, it was necessary to put in place daily care after the resection for 6 to 8 weeks and now we can speed up the process.”
For example, the hospital offers negative pressure therapy, using suction dressings. Used in home hospitalization, the process can double the speed of healing. Laser treatment is also possible for this pathology.
“Innovative approaches”
“When there is no abscess, it allows the resection procedure to be avoided, and thus avoids pain, with a success rate without recurrence of 90%, specifies Dr. Dine Koriche. It is a real advance for patients and we can also treat pathologies such as anal fistula, and avoid the old treatment by elastic tightening which can also be very painful.”
In parallel with these new techniques, the surgery department has launched two innovative approaches to optimize surgical results. Firstly: RAAC (for Enhanced Rehabilitation after Surgery).
This is a protocol put in place during and after the operation, to promote faster recovery of patients and reduce the length of hospitalization. “For example, for an intervention on a cancer colorectalit was necessary to count on about fifteen days of hospitalization, he indicates. With the RAAC, we go to three days! The same for a total hip replacement: we go from 10 to 20 days of care to one or two days.
Since 2021, the Fontainebleau hospital has been equipped with a surgical robot whose uses will be reinforced ©JVC/RSM7
The other new feature concerns pre-operative care: this is the prehabilitation. This is a preoperative physical preparation, which helps reduce the risk of complications. “Developed since 2013, it is a physical training started one month before the operation to increase lung capacity,” explains Dr. Dine Koriche.
To benefit from it, however, one criterion must be met (patient over 70 years old, have cardiopulmonary comorbidities, have iron deficiencies, a stoma or cancer)… The intervention must also be programmable one month in advance. “The principle is simple: the better prepared the patient is, the faster he will recover,” summarizes the surgeon.
“These protocols allow us to follow the recommendations to reduce the length of hospital stays, but above all they allow us to improve care,” concludes Arthur Moinet, deputy director of CH Sud 77. “There is a real momentum in the surgery center and the robot that we are going to continue to develop is a real element of attractiveness.”
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