New portable x-ray provides better care for surgical patients

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Dr. Peter Hayashida manipulates the mini C-arm for a procedure in which a fishing hook was removed from the patient’s hand. Registered practical nurse Mike Alfermann looks on.

Surgical patients at Rouge Valley are healing more quickly thanks to our physicians, staff and the use of new technology.

Both Rouge Valley Health System (RVHS) hospital campuses, Rouge Valley Centenary (RVC) and Rouge Valley Ajax and Pickering (RVAP), each now have a new portable X-ray machine. Known as a mini C-arm, this diagnostic equipment creates an X-ray picture producing a live and continuous X-ray image for surgeons during procedures to aid in the diagnosis and repair of feet, hand, wrist, and finger injuries.

The surgeons of Rouge Valley are taking full advantage of this new tool in use since last month to streamline care and ensure more immediate feedback on the success of procedures for patients.

“Because it’s portable and produces very low levels of radiation, I can use the mini C-arm in the operating room during delicate trauma or reconstructive surgeries for fingers, hands and feet,” says Dr. Allan Eckhaus, a plastic surgeon at RVHS. “The images it provides allow me to perform very precise surgeries with few complications, smaller incisions and quicker healing.”

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The mini C-arm works in much the same way the larger C-arm X-ray machine works, used at RVHS most often during hip replacement surgery. However, unlike the larger one, the smaller and portable version is being used in a number of different ways.

Dr. Peter Hayashida, chief of surgery at RVAP, explains that the mini C-arm is faster and more versatile.

“It has been used for closed reduction of fractures of the hand and wrist, it has been used for removal of foreign bodies (metallic) and diagnosis of hand and wrist fractures,” says Dr. Hayashida. “This new piece of equipment allows us to treat patients with these problems faster and with fewer steps involved. It simplifies the treatment algorithm.”

Some of the foreign bodies they treat this way include needles, metal, and leaded glass. As a relatively common injury, it is an important use for the machine. In the past at RVHS, patients with these types of injuries either had to wait for the C-arm to be removed from the operating room or wait to actually have a procedure completed in an operating room.

Now, patients can be treated in an ambulatory setting, such as the fracture clinic or emergency, in a timelier fashion, so they are not relying on another piece of equipment that is constantly in use. The mini C-arm also gives the doctor the ability to see the effect of their work in real time.

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The information received from the mini C-arm can provide confirmation of a fracture allowing the surgeon to set the fracture without surgery or to immobilize the fracture using stainless steel pins.

Explains Dr. Eckhaus: “It allows doctors to set fractures with the live feedback of the X-ray to check the accuracy of the position of the bones.”

As a surgeon, Dr. Hayashida has used the mini C-arm in the operating room. He says: “The orthopedic surgeons have also been using it (as well as the plastic surgeons) and find it is a simpler and faster way of making a diagnosis and expediting treatment for our patients.” The result is that patients rarely have to wait as they would have in the past.

Renate Ilse, program director of surgery, endoscopy and central processing at RVHS, says, “The biggest service improvement is around access to care. Instead of having to wait for diagnostic imaging, something that can take 30 to 60 minutes, or even more if a diagnostic imaging technician is called away for an emergency, the surgeon can examine and set the fracture immediately. Both the plastic surgeons and orthopedic surgeons are very enthusiastic about the machine.”

The initial expected usage for the mini C-arms is predicted to be more than 200 cases annually at RVAP, and more than 1,000 cases annually at RVC.

Although the mini C-arm is proving its value, the purchase of the machine would not have occurred if not for generous donors to the Rouge Valley Health System Foundation. Through fundraising events over the course of the year, the RVHS Foundation raised the funds needed to purchase the two machines.

The highest-profile fundraiser for the C-arm was the RVHS Foundation’s annual Gala, held in March. Visit www.myrougevalley.ca to see how donors were educated about the need for the mini C-arm through a Game of Thrones spoof, which debuted at the Gala, starring Rouge Valley’s medical staff.

Dr. Hayashida says, “We would like to thank all the donors who supported the purchase of this important piece of equipment.”