Commemorating the 25th anniversary of MUHCth On our anniversary, we interviewed MUHC Chief Surgeon Dr. Liane Feldman about the evolution of surgery at our hospital over the past quarter century.
What are the major changes in MUHC over the last 25 years?
Significant efforts have been made to improve postoperative recovery and reduce length of hospital stay and complications. Two of the main strategies for doing so are using less invasive surgery, laparoscopic and robotic surgery, and enhanced post-surgical recovery (ERAS) pathways.
As a tertiary and quaternary agency, we have contributed to the localization of complex care. That is part of MUHC’s mission. Examples include thoracic surgery, sarcoma, trauma, transplantation, heart, and vascular surgery. We have become more professional.
And, of course, the move to Glen was pivotal. The facilities are beautiful and the operating rooms are state-of-the-art. The renovation of MGH and the redevelopment of Racine are also exciting projects.
Tell me more about EnhancedRecovery pathways after surgery and their impact on hospital length of stay and reduction of complications?
The Enhanced Recovery After Surgery (ERAS Pathway) is a multidisciplinary care pathway that helps standardize all the different elements of surgical care. This starts with how we optimize and educate patients prior to surgery, through the use of advanced surgical and anesthesia techniques to reduce pain, to how we provide nutrition and exercise earlier. It consists of about 20 different care elements.
Colon surgery is a good example of the impact of ERAS. Twenty-five years ago, when we used open surgery and conventional therapy, a patient spent at least her week in the hospital. It was just routine. Now, thanks to this new approach, our colorectal surgery team has reduced his hospital stay to less than three days, and surprisingly, about 25% of patients are actually discharged on the same day as surgery. increase. We use digital health applications for remote monitoring. This is a huge success, not only because of the very high patient satisfaction, but also because it frees up hospital beds so more patients can access those resources.
What are your future challenges?
Surgery is now better, safer, and often the best way to cure illness and improve quality of life. Yes. As the population ages, more and more patients need and can benefit from surgery. This is good, but the ability to provide access to all these patients is not keeping up. Not only is there a shortage of staff, but also the needs of a growing population.
MUHC was a leader as an early adopter of minimally invasive surgery 25 years ago and an early adopter of ERAS 15 years ago. We must now prepare ourselves to lead his next 25 years. Surgery continues to evolve, becoming less and less invasive, but maintaining it requires new robotic equipment, new people with these skills, new approaches to training, interventional science research and innovation programs. .
Where were you 25 years ago?
I wish I was here at MUHC! In 1997 I was chief resident. I was at Montreal General Hospital. I too she was very pregnant in November 1997. Son Zach was born shortly after the Ice Storm, when he turned 25 in January.