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Woman And Infants

Press Release

Hospital named Center of Excellence in MIS
08/28/2013

Women & Infants Hospital of Rhode Island was recently designated a Center of Excellence in Minimally Invasive Gynecology (COEMIG) by the Surgical Review Corporation, an affiliate of the American Association of Gynecologic Laparoscopists (AAGL), for its commitment to offering women the most effective diagnostic and therapeutic techniques in minimally invasive surgery.

The news came on the heels of the latest expansion of capabilities in the hospital's Robotic Surgery Program for Women with the installation of Firefly Fluorescence Imaging, which uses an injection of special dye and a camera filter to enable gynecologic oncology surgeons to remove just the sentinel lymph node to test for endometrial or cervical cancer.

"These are both key developments for women in this area as we work diligently to offer them the region's most expansive minimally invasive surgery program," says Charles Rardin, MD, director of minimally invasive surgery for Care New England, which includes the program at Women & Infants. "Our patients lead busy lives and cannot spend weeks recovering from surgery. Minimally invasive and robotic surgery gets them back on their feet quickly.

"Being named a Center of Excellence in Minimally Invasive Gynecology ensures women needing surgery for problems ranging from cancer to pelvic prolapse to endometriosis, as well as those needing hysterectomies, that Women & Infants is the best option for them."

COEMIG designation has only been available to hospitals since 2011, having previously been only awarded to surgeons in the United States. COEMIG is now available to facilities and surgeons worldwide. The designation was created to help patients needing minimally invasive surgery identify surgeons and facilities that offer excellent care with state-of-the-art equipment and the latest procedures.

To earn the designation, a hospital must meet a rigid set of standards and maintain a central outcomes database, which ensures the care provided in the hospital is of the highest quality, and leads to new standards and best practices. The database essentially highlights care that is evidence-based in practice not in theory.

Single-site surgery

Women & Infants has steadily expanded the capabilities of its minimally invasive surgery program since opening the region's only robotic surgery suite dedicated to women's needs in 2010. In April, just months after the hospital marked its 1,000 robotic surgery, the Robotic Surgery Program for Women added Single-Site Instrumentation, which enables surgeons to perform some procedures through just one small incision instead of the standard four incisions for robotic surgery.

"The more slender instruments enhance the surgeon's skills and make the surgery even less invasive for the patient," Dr. Rardin notes. "This gives our patients one of the most cosmetically appealing surgical results possible."

Firefly

In July, gynecologic oncology surgeons began using the Firefly system, which allows them to remove the sentinel lymph node in the pelvic area. The sentinel node is the first in a chain of lymph nodes draining a specific area where a cancer develops and is the first node where cancer cells may metastasize too. Being illuminated – like the tail of a firefly – by the fluorescent dye injected into the cervix, allows the surgeon to easily visualize this node and remove it for evaluation.

"If there is cancer present in the lymph nodes, there is cancer present in the sentinel node. It is less invasive and has less potential for problems like lymphedema in the future for the patient if we can identify the sentinel node and remove just that," explains Richard G. Moore, MD, a gynecologic oncologist with the Program in Women's Oncology at Women & Infants. "We are one of the only sites in the Northeast using this technology."

Dr. Moore anticipates that Women & Infants' standard of care for women diagnosed with either cervical or endometrial cancer will soon be sentinel node removal with the Firefly system. The oncology surgeons already treat breast and vulvar cancer with sentinel node dissections in a similar fashion.

"We are ahead of the curve technologically, which allows us to provide minimally invasive oncology surgery and sentinel node evaluations in women diagnosed with gynecologic cancer," he says, adding that all of the hospital's gynecologic oncologists perform procedures using Firefly.

The technology also has application for urogynecologic patients experiencing prolapse and incontinence, Dr. Rardin adds. The dye is used with these women to illuminate key blood vessels to help the surgeon work.

"Fluorescence imaging gives the surgeon the ability to see the patient's anatomy clearly as we work to help her," Dr. Rardin, a urogynecologist, points out.

For more information on gynecologic oncology surgery, women or referring physicians can call the Program in Women's Oncology at (401) 453-7520. Women experiencing prolapse or incontinence can call the Division of Urogynecology and Reconstructive Pelvic Surgery at (401) 453-7560.

About Women & Infants Hospital

Women & Infants Hospital of Rhode Island, a Care New England hospital, is one of the nation's leading specialty hospitals for women and newborns. The primary teaching affiliate of The Warren Alpert Medical School of Brown University for obstetrics, gynecology and newborn pediatrics, as well as a number of specialized programs in women's medicine, Women & Infants is the eighth largest stand-alone obstetrical service in the country with nearly 8,400 deliveries per year. In 2009, Women & Infants opened the country's largest, single-family room neonatal intensive care unit.

New England's premier hospital for women and newborns, Women & Infants and Brown offer fellowship programs in gynecologic oncology, maternal-fetal medicine, urogynecology and reconstructive pelvic surgery, neonatal-perinatal medicine, pediatric and perinatal pathology, gynecologic pathology and cytopathology, and reproductive endocrinology and infertility. It is home to the nation's only mother-baby perinatal psychiatric partial hospital, as well as the nation's only fellowship program in obstetric medicine.

Women & Infants has been designated as a Breast Center of Excellence from the American College of Radiography; a Center for In Vitro Maturation Excellence by SAGE In Vitro Fertilization; a Center of Biomedical Research Excellence by the National Institutes of Health; and a Neonatal Resource Services Center of Excellence. It is one of the largest and most prestigious research facilities in high risk and normal obstetrics, gynecology and newborn pediatrics in the nation, and is a member of the National Cancer Institute's Gynecologic Oncology Group and the National Institutes of Health's Pelvic Floor Disorders Network.

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