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General Surgery: The Growth of Surgeries at Cape Fear Valley Health


People have surgery for a variety of reasons. Sometimes it is to diagnose a problem. Other times it is to treat a disease or disorder. In many cases, the surgery can save a life.

Cape Fear Valley Health performs more than 15,000 surgeries a year, both inpatient and outpatient. That makes surgery one of the health system’s busiest and most important service lines.

As the flagship hospital, Cape Fear Valley Medical Center performs a majority of the health system’s inpatient surgeries. The number hovers around 4,500 annually.

Susan Dees, Corporate Director of Surgical Services, says the steady performance is impressive, due to the recent economy and insurance industry changes.

“Most people are just putting off surgery,” she said. “It’s like that at hospitals nationwide. We’ve been very fortunate we haven’t seen a big dip.”

What is more impressive is how the main hospital’s general surgery volumes are actually growing. Often considered a hospital’s “bread and butter” service line, these procedures focus on abdominal organs, such as the gastrointestinal tract, liver, pancreas and gall bladder. They can also deal with the skin, soft tissue, trauma and vascular surgery.

Dees says gastric bypass, ear, nose and throat (ENT), and neurosurgical procedures are doing particularly well. She expects vascular surgery to do the same this year, thanks to a returning surgeon.

One of the area’s only two Cleveland Clinic-accredited cardiothoracic surgeons briefly left the area, but has since returned. It has allowed heart procedures, such as coronary bypasses and open-heart surgery, at the Heart & Vascular Center to resume at a steady pace.

Hoke Hospital in Raeford is also experiencing a rise in surgeries. The new facility’s operating rooms (ORs) now operate three days a week to accommodate demand. Bladen County Hospital in Elizabethtown should see similar growth with the arrival of a new general surgeon at Bladen Healthcare.

Ambulatory Care

Treating patients without hospitalization is called outpatient or ambulatory care. Outpatient procedures at Cape Fear Valley Health are growing just as fast, if not faster, than general surgeries. The insurance industry’s move to lower patient treatment costs and a greater willingness by patients to recover at home is fueling the growth.

The number of ambulatory procedures has tripled over the past 30 years to more than 54 million annually. Eye operations, joint and muscle repairs, lumpectomies, nerve treatments and gall bladder removals are the most common.

The popularity of ambulatory care centers, which specialize in outpatient procedures, has followed suit in the U.S. Cape Fear Valley’s facility is called the Short Stay Center, and it is located at Cape Fear Valley Medical Center.

Dees says plans to renovate the second floor unit will accommodate the expected growth. The goal is to keep the Short Stay Center competitive with other ambulatory centers in the region.

Highsmith-Rainey Specialty Hospital also performs outpatient procedures at its SurgiCenter. Cataract surgeries have quickly become the hospital’s biggest growth market. In 2014, the hospital’s operating rooms performed 2,000 cataract procedures. That number climbed to 2,700 last year.

Specialty Procedures

All the outpatient growth excites Dees, but inpatient surgeries are her primary focus. It’s her job to keep Cape Fear Valley Medical Center’s main ORs busy and on schedule.

The medical center’s busiest ORs may be the two assigned solely for joint replacement procedures. Dickson Schaefer, M.D., says the dedicated rooms have helped his practice greatly. His hip and knee replacement cases have doubled in recent years.

“My surgery volume has grown significantly,” he said. “They are able to clean one room and get it ready for another case while I am operating in the other room.”

Dr. Schaefer has begun discharging joint replacement patients the same day to reduce time patients have to spend in the hospital. He says many patients prefer to recover at home.

He modeled the practice after an Ohio-based healthcare system’s discharge model. The goal is to get patients back on their feet and moving as quickly as possible.

“We’re doing wellness surgery, not sick surgery,” Dr. Schaefer said. “Getting them home faster helps them psychologically to feel better, faster.”

Cape Fear Valley’s urology numbers are also on the rise, especially kidney stone procedures. Juan Lopez, M.D., with Cape Fear Valley Urology, says the growth stems from North Carolina residing in the “Kidney Stone Belt.”

The term refers to a region in the Southeast, where the rate of kidney stones is excessive. North Carolina reportedly has the highest incidence of kidney stones in the nation. Caucasian males are particularly at risk for the condition.

“The summers are just hot and humid, here,” Dr. Lopez said. “People get dehydrated, leading to kidney stones. They keep us pretty busy.”

The urologist and his colleagues use everything from special endoscopes to laser lithotripsy to treat the painful mineral formations. The practice also treats plenty of prostate and bladder cancers, incontinence and other minor conditions, using Highmsith-Rainey’s ORs.

Urology procedures at Cape Fear Valley Medical Center look to also increase with the arrival of Landon Nguyen, M.D., a robotic surgery specialist. Robotic surgery can perform several types of complex procedures, often with more precision, flexibility and control than conventional techniques.

Dr. Nguyen will use Cape Fear Valley’s da Vinci robotic surgery system. It’s capable of treating a number of urology conditions, including prostate cancer, kidney disorders or cancer, urinary blockages and bladder cancer.

Cape Fear Valley Ear, Nose and Throat welcomes a new physician, as well: Jennifer Tartaglia, M.D. The ENT specialist and her colleagues perform a wide range of inpatient and outpatient procedures. They include thyroid treatment, salivary gland procedures, tonsillectomies, and repair of sinus and intranasal diseases.

By: Donnie Byers