Orthopedic technology at Dartmouth General Hospital
Photos by Jenn Nauss/Cooked Photography
“I love the can-do culture that we have here at Dartmouth General, and I think the agility here makes it much easier to move forward with new technology and new ideas.”
Dr. Jennifer Leighton is leading the way into an operating room at the Fred Smithers Centre for Orthopedic Care, to be joined by fellow orthopedic surgeons Dr. Brendan O’Neill and Dr. Jhase Sniderman. The entire surgical team at Dartmouth General Hospital has been leading the way since December of 2019, when a transformational gift from local business leader Fred Smithers helped to create this state-of-the-art Orthopedic Centre.
“It would be hard to get our patients home much faster than we have been doing,” says Dr. Leighton. “We do over 80 percent outpatient surgery which would be if not the top, amongst the top in the country.”
“We’re the highest volume hip and knee centre in the province,” adds Dr. Brendan O’Neill, Dartmouth General Hospital site lead, orthopedic surgery. “The fact that we do 80 percent of them as an outpatient procedure not only increases the volume, but the cost savings by not having patients come into the hospital overnight is immeasurable. Those beds are now available to be used for patients who are ill and need them. Our system is under stress and so the transformation here has been increasing volume as well as increasing outpatient surgery.”
A big part of that transformation arrived in 2022, in the form of a $2 million Mako SmartRobotics system, funded through generous donations to the Dartmouth General Hospital Foundation. In November of that year, Dr. Leighton again was leading the way when she used that robotic technology to plan and guide a total hip replacement surgery – a first in Canada.
“It was a great team moment, all the nurses and staff preparing for that and we all felt like we executed it together,” says Dr. Leighton. “We went for a dinner to celebrate. And that patient is still doing great.”
That patient was the first but there have been close to a thousand robotic-assisted surgeries since at Dartmouth General, leading the way across the country. The technology allows for precise surgical plans tailored to each individual.
“We have a lot of patients coming in seeking technology now, which is a huge shift from when we started,” says Dr. Leighton. “It’s really de-escalated stress, improved reproducibility and I’ve been quite pleased seeing a decrease in pain and swelling in earlier rehab, with patients getting back to activities faster. People are talking about what a great experience they’ve had coming through the outpatient pathway and working with our team. It’s really surpassed my expectations for what I thought was going to be possible here when I first started.”
“I think the transition has really built upon the clinical excellence that always existed at Dartmouth General Hospital,” adds Dr. O’Neill.
The expertise at Dartmouth General Hospital has not only generated proven results, it’s also been a draw for other surgeons. Dr. Jhase Sniderman’s roots are in Toronto where he’d often visit his grandfather’s record shop — his grandfather being the legendary Sam “The Record Man” Sniderman. Jhase came to the Maritimes to play hockey, and he was an accomplished goalie at the university and junior level. After training as an orthopedic surgeon, he moved back East with his family to be part of the team at Dartmouth General.
“It’s just a privilege to be here and work with this hospital,” says Dr. Sniderman. “The technology was a draw, and Jennifer Leighton is a big name in Canada. I knew if I could work with someone like that, I’d learn so much. I came for my visit and was shown around. The team here just seemed to be at a really high level and I wanted to be part of that.”
Health care history in Atlantic Canada was made once again at the Fred Smithers Centre for Orthopedic Care this past February 20th. Dr. Sniderman, along with the dedicated medical and support teams, completed eight hip replacement surgeries in one operating room that day, even finishing a few minutes ahead of schedule. This surpassed the previous record of seven surgeries in one day that Dr. Sniderman had set before Christmas, then matched again in January.
Dr. Sniderman says each patient received the same high level of attention and care, with the difference happening in the time between those operations.
“The room gets cleaned faster, the nurses set up faster, the implants get turned over faster, so it just leads to better use of operating room time,” says Dr. Sniderman. “Everyone works together as a team and more patients have their surgery sooner. The only reason to do this is to make a positive difference in people’s lives.”
Productivity is a word you hear often around the Fred Smithers Centre for Orthopedic Care, along with the word precision.
“Precision and efficiency are what we’re aiming for with surgery,” says Dr. O’Neill. “The addition of enabling technologies such as robotics allows us to further that goal and achievement.”
“There are still lots of knees and hips going in without the robot and those are doing well too,” adds Dr. Leighton. “What I’ve seen from my own practice with robotics is that a lot of energy is front-loaded into that preplanning phase and then during the surgery, the actual execution part is fairly fast. That means less instrumenting, fewer holes in the bone for the patient, and we’re seeing less swelling and pain after surgery. I’ve been very happy to see that speedy recovery.”
The orthopedic team members are now hoping to continue on this path and add a second robot to Dartmouth General Hospital. The price tag would again be close to $2 million but the surgeons say there is a proven return on that investment, not only for the patients but also for the health care system. Studies with the Hospital’s current Mako robot show a decreased rate of repeated or “redo” surgeries.
“We fortunately have that information to go on that says it’s a cost-effective strategy to provide high quality care,” says Dr. Leighton. “We feel very confident going forward that our next robot will have the same value to our team.”
Dr. O’Neill says it’s the technology but also the team atmosphere inside the Hospital and outside into the broader community that is making a difference. Generous donors have included Fred Smithers, The River Philip Foundation, The David and Faye Sobey Foundation, TD Bank, The J&W Murphy Foundation, The Hewitt Foundation, The Jim Pattison Foundation, Maurice and Ann Doucet and The Dickey Family. There has also been great support from the Burnside business community.
“We are thankful we can go to our Dartmouth General Hospital Foundation and say we have a great idea that’s going to move health care forward in Nova Scotia and they respond to it,” says Dr. O’Neill. “We have the personnel and culture to get things done. I think that’s what has really separated Dartmouth as a center of excellence is the ability to come up with an idea that’s going to make a difference then move it to action very quickly.”
“I think we’ve done a great job here at Dartmouth General building that can-do culture,” adds Dr. Leighton. “We’re happy to add to that and bring it to our patients.”
