A tour of Adirondack Medical Center’s new surgical wing
SARANAC LAKE — A group made up mostly of village board members gathered around a medical-grade dumbwaiter in “bunny suits”: white coveralls, puffy blue caps and blue booties.
Arthur Handley, director of perioperative services at Adirondack Medical Center, started the tour of the hospital’s new facilities with an explanation of the hospital’s new sterile core.
“The infection control parameters that take place downstairs, plus the assembly of all the instrumentation — that is the root of all success in the operating room,” Handley said. “We’re only as good up here on any given case as the instrumentation we have available.”
The core, six operating rooms, an MRI suite, a loading dock and storage spaces were added in a 37,000-square-foot expansion to the region’s main hospital, starting in 2016. This construction, along with the recently opened Lake Placid Health and Medical Fitness Center, was part of a $36 million project by Adirondack Health.
The dumbwaiter ferries surgical implements to and from the core one floor below. To the left and right of the lift are the six new operating rooms, opened in late 2018.
Handley lead the group into one of the new rooms. It’s somewhat round and 625 square feet, near double the size of one the old rooms. Lights, monitors and other equipment hang from the ceiling around an operating table in the center of the room.
In the old rooms, Handley said the most of the equipment was delivered by carts, taking up space that was already at a premium.
“We have five exactly like this one here,” Handley said. “We can do different procedures interchangeably, but they do have rooms that have specialized equipment.”
This OR was currently set up for holmium laser procedures — typically used to pulverize kidney stones, Handley said.
“We generally do 4,000 procedures or so a year at Adirondack Health, and that is only in the operating rooms,” Handley said.
More than 3,000 other minor surgeries and operations, such as colonoscopies, are done in the ambulatory surgery areas, Handley said.
He pointed to the intentional design of the rooms — from the wall color and lighting to the seamless, gray floor.
“The floor is a big deal to us,” Handley said. “Every once in while during the course of a procedure, we may drop a needle or a blade or something like that. If you want to be able to locate that, it has to contrast.”
Another technology Handley said the hospital was glad to introduce in these new ORs is radio frequency sponges. The sponges used during surgery contain RF thread and an RF chip.
“It’s very important that you count everything as far as an open procedure,” Handley said.
But now, in addition to counting the tools used in surgery at the conclusion of a procedure, OR staff wand patients with what looks like a tennis racket — one that beeps like a Geiger counter if anything has been left behind.
Handley led the group to the sixth OR, the hybrid room, unique among the new facilities. Large imaging equipment dominates the room, with an automated C-shaped arm that tracks around a pedestal mounted table and monitor. On screen, the vascular system of an anonymous human’s chest is shown.
“This is a room where we would do minimally invasive procedures using all the wonderful technology that we have in here,” Handley said.
Adirondack Health CEO Sylvia Getman said the imaging equipment is most frequently used for vascular surgeries by Dr. Claude Roland. Staff call it the hybrid room because, should it need to be used for a different type of surgery, other equipment can be outfitted as needed.
“We have all GE furnishings for our hybrid room,” Handley said. “GE will only authorize two companies in the country to install the floor for their hybrid room, and the reason for that is because it has to be absolutely level.”
The room is 800 square feet. The poured, rubberized floor cost $158,000 to install.
“A lot of operating rooms where (vinyl) floors are installed, we’ve had a heck of a time trying to repair them, getting them to stick, doing moisture content surveys on the flooring, and it just is one thing after another,” Handley said.
The four old ORs are being renovated for ambulatory surgery use, but in the process Getman said contractors found asbestos in the walls. The resulting abatement process has stalled their opening.
“It depends on how long the asbestos takes,” Getman said. “By late spring I’d say.”
Next in the tour was the MRI suite that opened in mid-December. It is the first of its kind in Saranac Lake. In the past, patients in need of the procedure had to make do with the comparatively louder, smaller and slower operating mobile unit that had been in use at AMC for the last two decades.
“We were actually losing some patients to open MRIs an hour away,” said Hannah Hanaford, executive director of the Adirondack Health Foundation, “because they were claustrophobic or afraid. And these helps us keep our local patients local.”
MRIs use powerful magnets for imaging the human body. The $1.1 million magnet in AMC’s MRI suite does not turn off, according to Jim Sabin, director of diagnostic imaging.
As a result, safety is a big concern. The area is on lockdown at all times, and patients are wanded on entrance. No equipment comes in that is not marked MRI-safe. Additionally, the doorway that leads to the machine itself is inlaid with a metal detector that howls and lights up if it detects ferrous metals.
“There is a safety function called a quench that essentially, in an emergency, can turn the magnet off,” Sabin said. “It’s about a two- to three-week process to ramp the magnet back up, and about $50,000. So we try to avoid that at all costs.”
Sabin graduated from North Country Community College’s Radiologic Technology program in 1997 and has worked for AMC ever since. He said 80 percent of the hospital’s techs also came through the local program. Since he’s been working there, Sabin said he’d see patients panic and back out of MRIs in the mobile unit.
“You’d give them a bit of a sedative … then go back in,” Sabin said. “We haven’t had to do that here.”
The machine was built with a wide bore magnet, so the table inside is bigger. The room’s lighting can be adjusted, and the ceiling depicts a blue sky and lush greenery. A patient can also hook their devices up in the control room, and use a special pair of headphones in the machine “so you can listen to your own playlist while you’re in there,” Sabin said.