Success Story: NuBoom Delivers for Vascular Surgeon
By Matt Skoufalos
When vascular surgeon Chris LeSar goes to work, he’s typically not thinking of his own comfort, but that of his patients. The endovascular operations he performs are often conducted minimally invasively, the better to speed recovery and limit intrusion into the body. His work requires such fine control that it is conducted with the aid of fluoroscopy and an injectable, radioactive dye that allows him to trace the location of arterial blockages. Once LeSar locates those blockages, he can use catheters to inflate the artery with a balloon or prop it open with a stent to return normal blood flow to the area.
LeSar practices in Chattanooga, Tennessee, the heart of the South – which, as he describes it, is riddled with peripheral artery disease. Many of his patients suffer from diabetes, high blood pressure, and high cholesterol, and most of them smoke, he said.
“It’s an endemic area for that,” LeSar said. “I operate on people 35 years old all the way to 95 years old. Some people who are 35 have been smoking for 20 years. They smoke one to two packs a day, and that’s going to damage and destroy your arteries.”
“A lot of people know that smoking can give you cancer, but they don’t know that it can block your arteries and damage your arteries,” he said.
Arterial issues can present as leg pain, discomfort when ambulating, or sores on the feet that won’t heal or which display necrotic tissue. Sometimes the blockages are so severe that patients don’t have the blood flow they need to keep their limbs alive, LeSar said. Once he can address the problem of the blocked artery, he can often save the legs of his patients, allowing them to walk again, and therefore, to exercise, which can facilitate the weight loss and improved cardiovascular health they are lacking.
“I’m really trying to help people save their legs and become healthy again,” LeSar said. “If someone has pain when they walk, or a sore on their foot that doesn’t heal, they have high risk of losing their leg.If they can get there, a doctor can save their life.”
While LeSar concerns himself with helping his patients to move more comfortably, he is himself often performing the operations that allow them to do so in 40 pounds of lead. To protect his body from the ionizing radiation of a fluoroscopy unit and the real-time internal view it provides him of his patients’ bodies, the surgeon must work in a fully leaded gown.
“You get your workout, that’s for sure, but I want to live long, and I want to do this for a while,” he said. “Radiation is cumulative. I have to hold all that off me if I can.”
Although it affords him necessary protection, the lead-lined gown also limits the versatility of LeSar’s movement, particularly if the visualization array in his operating theater is provided by a traditional, stationary monitoring system.
“If the monitor’s only in one place, I have to turn my body or my neck sometimes to see what I’m doing,” LeSar said. “It doesn’t give you the versatility. You get uncomfortable, fatigued, and nobody wants a surgeon who’s tired. A surgeon who’s tired is not optimized to do his job. You want to have a comfortable environment, you need to see what you need to see, and you might want to have multiple views at once.”
Most of the C-arms in the angiography and fluoroscopy suites consist of a single monitor attached to a tower with a variety of peripheral devices connected to it, LeSar said. The setup is visible to the surgeon, but typically is situated fairly far away from the bedside. But in other operating suites in which LeSar practices, those problems are addressed with the aid of the CV Medical NuBoom visualization platform.
“It allows me to bring [things] up close and personal so I can see it very, very well,” LeSar said. “When you’re navigating [the human body], you need to see where you’re going. I can look at a magnified image the size of a quarter on the big screen.”
The NuBoom provides surgical visualization by allowing doctors like LeSar to align different views of the operating field through multiple monitors mounted on multiple arms. Just like a pilot relies upon his cockpit and radar displays to navigate in space, LeSar makes use of the variety of visualizations provided by the NuBoom to reach the surgical targets in the body and make necessary repairs. He can compare pre-surgery imaging with the patient’s internal topology, monitor vital signs, and adjust his approach accordingly.
“[Surgery] is a dynamic situation,” LeSar said. “Things move pretty quickly in those environments and I’ve got to make quick decisions. [The NuBoom is] just a way to enhance the doctor’s ability to make decisions and see what needs to be seen.”
“We can move the C-arm, we can move the patient, and we can see in different parts of the body,” he said. “We can start at the ankle and look all the way up to the brain.”
Although he has worked in hospital systems with expensive angiography suites and large, mounted C-arms, much of LeSar’s work also can be performed in a smaller outpatient surgery center with the aid of a smaller NuBoom C-arm without him compromising on the visualization he needs to do his job.
“The NuBoom gives me the feel of being in an operating room,” LeSar said. “[It] allows me to have a functioning operating space where I can visualize everything in an outpatient environment. I can turn my body to be in the most comfortable spot and my vision to the most comfortable spot. This helps with that fatigue factor.”