Dr. Joe Nessler recently had an idea for an improvement at St. Cloud Surgical Center that is literally bright.
Nessler, who joined St. Cloud Orthopedics in 1991, did some research into how to better reduce chances of infection for his patients and came across the trademarked Germ-Zapping Robot. Made by a company in San Antonio, it uses full-spectrum ultraviolet light to blast pathogens that can cause health care-associated infections.
Late last year, St. Cloud Surgical Center became the first ambulatory surgical center in the nation to use the robot.
“The future of orthopedic surgery is going to include more and more joint replacement operations and the best, most cost-efficient method is to move them from in-hospital procedures to out-of-hospital venues like ours,” said Nessler, 54. “Our biggest concern is infection. We want to have a more sterile environment than traditional operating rooms. So we were looking at UV as an option.”
Nessler said using ultra-violet light to kill germs has been possible for many years, but only recently has it been possible to do it quickly enough to meet the demands of a hospital or surgical center.
That’s where Dora comes in. That’s the name the surgical center staff came up with for the robot, which is about the same height as R2-D2 from the Star Wars films. Dora stands for “disinfecting operating room apparatus.” The ultraviolet light it produces is 25,000 times more intense than sunlight.
Julie Tonsager, an operating room team leader, often uses Dora. She wheels it into an operating room just before a procedure and Tonsager sets Dora up in a couple of positions to get the most coverage. Then, it’s as simple as plugging in the machine, setting motion sensors to ensure the room won’t be accidentally entered and leaving the robot alone for 5-10 minutes.
The top of the machine lifts up to reveal UV bulbs that pulse with xenon gas at high intensity in a non-mercury flashlamp. It’s safe to see through the door window. Nessler and Tonsager can watch its progress. But for microorganisms, it’s deadly. The exposure penetrates cell walls and fuses DNA so reproduction or mutation is impossible. It has proven to kill Clostridium difficile, norovirus, influenza and Methicillin-resistant Staphylococcus aureus. Nessler said the machine would rid a room of the Ebola virus in two minutes.
“The fact that it can kill C-diff got a lot of momentum for us,” Nessler added.
It’s not cheap. While each sale is independently negotiated, the Xenex robots cost about $100,000. Mark Stibich, who has a doctorate in epidemiology, invented the machine. He said you have to gauge the cost against the risk of infections.
The Centers for Disease Control and Prevention estimates 2 million people get a hospital infection annually and more than 100,000 die from health care-associated infections.
“The average infection is going to cost at least $15,000, and the hospital or surgical center isn’t getting reimbursed for that,” Stibich said. “So you have to factor that in. If you prevent two infections a year, you’ve got the machine paid for in four years.”
Stibich began developing the technology in 2009 and had some beta customers by 2011.
“In 2012, we finally went full bore with our sales team,” Stibich said. “Since then, we’ve been on a horizontal expansion. We’re already in 250 acute care hospitals across the nation and now we’re moving into surgical centers and long-term care facilities.”
St. Cloud Surgical Center was the first ambulatory surgical center outside of a hospital in Minnesota when it started more than 40 years ago. The second-oldest of such facilities in the nation, it has since expanded to a building at 1526 Northway Drive that features 11 operating rooms. More than 120 doctors use the facility and more than 11,000 procedures were performed on patients there in 2014.
The surgical center performed its first total hip replacement on an outpatient in November. Partial and total knee replacements also are routine operations, Nessler said. In most cases, the patient goes home the same day of surgery.
“We expect we’ll be performing those operations with increasing frequency, and the Xenex machine has shown that it can produce a decrease in hospital-acquired infections,” Nessler said. “It’s an expensive capital outlay, but one we can justify if the future holds.”
The robot doesn’t replace traditional cleaning but rather acts as insurance behind it.
“We’re going to expand where we use it eventually to all areas, including the lobby,” Tonsager said.
Earlier this month, St. Cloud Surgical Center took possession of a second robot. It went into service before employees could name it.
“The technology may sound expensive but there’s value in it, Stibich said. “We hope in a few years this will be the new standard of care.”
Follow Kevin Allenspach on Twitter @KevinAllenspach. Call him at 255-8745.
For more about St. Cloud Surgical Center, visit www.stcsurgicalcenter.com