UB Physician Prime Mover in Adapting Minimally Invasive Surgery Techniques to Children's Ailments

BUFFALO, N.Y. -- Pediatric surgeon Philip Glick, M.D., is on a crusade to convince the medical community worldwide that minimally invasive surgery -- which can lessen pain, hospitalization and recovery time for young patients, as well as lower health costs -- should be the new surgical standard for treating conditions in children and adolescents.

One way he is spreading his message is through a 21st-century version of show-and-tell: the surgical equivalent of teleconferencing. Glick operates in Buffalo while an audience gathered at a distant site watches in real-time through the technology of fiberoptics.

Glick, professor and chair of surgery in the University at Buffalo School of Medicine and Biomedical Sciences and surgeon-in-chief and clinical director of pediatric surgical services at Children's Hospital of Buffalo, is the visionary behind a $1.5 million Miniature Access Surgery Center (MASC) at Children's that has captured the attention of pediatric surgeons worldwide since its opening in October 2001.

Believed to be the most sophisticated facility of its kind in the world, the MASC is devoted to performing, teaching and researching minimally invasive surgical techniques and adapting them for children and adolescents. (Glick chose the term "miniature access" rather than "minimally invasive" in naming the center because it was more understandable to parents.)

Glick's first telecast was transmitted last October to a meeting of the American College of Surgeons in New Orleans. On Friday (March 15, 2002), he will correct a congenital chest wall deformity called "funnel chest" in a teen-aged boy in surgery that will be telecast in real-time from 10 a.m. to noon to attendees at the Eighth World Conference of Endoscopic Surgery at the New York Hilton. The telecast will be viewed at a demonstration booth sponsored Stryker Communications Corp., which provided a grant to Children's Hospital to help equip the new surgical center.

The procedure, called minimally invasive pectus repair, will involve inserting a removable metal strut into the patient's chest cavity through small incisions on either side of the chest. The

strut supports the chest while the deformed cartilage remodels into a normal shape. Glick has performed the surgery on more than 50 children with excellent results.

Compared to the standard open-chest approach, the minimallly invasive technique causes significantly less pain to the child, cuts surgical time in half and hospitalization by 1 1/2 days, and shortens time to complete recovery by up to seven months, Glick said.

Marc Levitt, M.D., UB assistant professor of surgery and pediatrics and medical director of the new surgical center, will moderate the procedure in New York City at the Stryker booth.

Glick, meanwhile, will be working in an operating theater custom-designed for multidisciplinary, minimally invasive surgeries, including laparoscopy, thoracoscopy, endoscopy, arthroscopy and cystoscopy. All equipment, suspended from ceiling booms, is controlled by voice-activated computer and directed by the surgeon speaking into a headset. Images from deep in the body transmitted from cameras embedded in the tips of endoscopes placed at the surgical site are projected on flat-screen televisions in the surgical suite.

Situated unobtrusively in the corner of each room is a communication control center that allows images captured by these cameras to be telecast to any location in the world equipped for teleconferencing and provides the MASC with expansive telesurgery and "telementoring" capabilities.

"One of the things that is different about our program in Buffalo compared to others around the country," said Glick, "is that our entire faculty has embraced the goal of converting over to minimally invasive surgery as a way to think about every operation."

At the time they began the transition, surgeons at Children's were applying minimally invasive surgical techniques to about five percent of their cases. That number is now more than 50 percent; the goal is to reach 100 percent. Convinced that these proven techniques provide a host of benefits to patients and their families, as well as savings in health-care costs, UB surgeons now want to do for other pediatric surgery training programs in the country what they've done for their own.

"There are some programs out there that are still at 5 percent, so the children in those cities are not benefiting from these great techniques," says Glick. "We'd like to help change that."

To view the surgery at the Eighth World Conference of Endoscopic Surgery meeting at the New York Hilton, contact Marc Levitt or Dan Couchman at the Stryker Booth (Booth 379) on site.