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Robotics are Changing The Future of Urology

In recent medical history, many surgical procedures have evolved from open techniques to those that are minimally invasive. This is largely due to the advent of robotics. The first robotic-assisted surgery was performed in 1985, and the development of the popular da Vinci Surgery System occurred 15 years later. Since that time, nearly twenty years of continuous development has taken place. Now, many surgeons and patients prefer the robotic route for its smaller incisions and more predictable outcomes. At one time, robotic-assisted procedures were exclusive to cardiothoracic procedures. Now, more than half of urologic and gynecological procedures also rely on robotics. As a result, more physicians and residents are interested in training in it.

Robotics in Urology
Urology has historically been a technologically innovative field of medicine. The advantages of robotics have been demonstrated in numerous procedures, particularly cases of urologic cancers. These include:

Robotic Prostatectomy. Robotic-assisted radical prostatectomy is preferable because it is considered a nerve-sparing, minimally invasive procedure. The precision of robotics is also associated with greater preservation of erectile function and reduced bleeding and scarring. Before robotics, radical prostatectomy was performed using open or laparoscopic techniques. At this time, robotic-assisted surgery is the new standard.
Robotic Partial Nephrectomy. In the performance of partial or total nephrectomy, robotics consistently achieves shorter operative and recovery times. Patients are typically released from the hospital sooner due to the precision of robotic-assisted surgery. The use of robotic and laparoscopic techniques has largely eliminated the need for partial rib dissections to complete the partial or total nephrectomy.
Radical Cystectomy including Intracorporeal Diversions. Regardless of technique, this procedure remains complex. However, the use of robotics has improved efficiency and patient outcomes, achieving shorter hospital stays, reduced pain, and less […]

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    Expectations for Paramedics are High. We Can Help You Meet Them.

Expectations for Paramedics are High. We Can Help You Meet Them.

Years ago, a day in the life of a paramedic may have involved basic patient or casualty transport. Since that time, expectations have gone from providing minimal interventions on scene or during transport to providing comprehensive emergency care. The care that today’s paramedic is expected to provide, without hesitation, spans the realm of trauma and medical procedures.

Paramedics must now develop competency in multiple invasive procedures. Examples include airway management via endotracheal intubation, tube thoracostomy, needle thoracentesis, surgical cricothyroidotomy, and several other emergency procedures. To be confident in making vital medical decisions on the fly, the paramedic must be competent in the performance of each. Strong working knowledge of human anatomy is the baseline for this competency. Studies indicate that the best way to gain skills is through real-life exposure and demonstration of procedures followed by the actual performance of these skills in a controlled environment.

“In a controlled environment” is key here. Not every paramedic is immediately competent in the various skills they will be required to demonstrate. Due to the nature of medicine, on the job training is simply not acceptable. With the demands on paramedics and first responders at an all-time high, the demand for suitable training modalities has intensified. Working on mannequin models doesn’t cut it. Like other vital medical personnel, paramedics need exposure to human tissue. A cadaver lab provides them with the perfect opportunity.

For many paramedics, the first clinical exposure they get to the human body is in a cadaver lab. Comprehensive training courses for first responders build familiarity with surface landmarks, internal structures, and other human characteristics that are vital to the successful performance of emergency procedures such as:

Airway management
Central access
Saphenous access
Suturing and ligation
Tourniquets and pressure dressings
Wound management
Improvised splinting
And […]

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    Pain Management Getting a Makeover in the Face of an Opioid Crisis

Pain Management Getting a Makeover in the Face of an Opioid Crisis

The opioid crisis has become a multifaceted problem that concerns physicians, patients, and the pharmaceutical industry. With litigation ongoing to determine whether or not corporations may be held responsible for the tragedies associated with opioid use, we are seeing one thing happen at breakneck speed: a marked decrease in the number of opioid prescriptions doctors are writing.

According to the healthcare consulting and outsourcing group IQVIA, opioid prescriptions dropped by 17% in 2018. Since 2010, when prescriptions were at their peak, they have fallen by 43%. We may look at this as a “good thing,” except that patients continue to deal with pain that, at one point, seemed to be manageable with the right medication. Here, we discuss a few of the bigger ideas that are currently being considered.
Safer Opioids
It may be difficult to believe that opioids can be made safe, but Collegium Pharmaceutical is trying. This company has made an extended-release oxycodone drug that delivers opioid medication consistently over time, even if the pill is crushed. The concept is that, with time-release, the drug becomes more difficult to abuse. At this time, analysts report that emergency room prescriptions for this drug have risen by 51% in the second quarter of 2019 compared to the same quarter last year.
Shifting Gears Completely
With much of the world shying away from opioids at this time, many investors are turning toward non-opioid methods of pain management. This doesn’t mean drug-free, but it does mean an opportunity to test drugs that are much less likely to have addictive qualities. One such drug is a sodium channel blocker, which has completed three Phase II studies. Another methodology, the use of cell therapy to treat low back pain caused by disc degeneration, […]

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    First Responders Benefit from Bioskills Training Using Cadavers

First Responders Benefit from Bioskills Training Using Cadavers

As technologies have improved, an increasing number of healthcare personnel receive training that is heavily reliant on simulation. Additionally, mannequins have improved in an effort to increase their lifelikeness. However advantageous current training may be for professionals like EMS and other first responders, there is no way that either virtual reality nor mannequins can replicate the variances of human anatomy. Multiple studies have indicated that surgeons, nurses, and other healthcare professionals demonstrate improved anatomical knowledge after participating in some type of cadaver training. Now, the same is being said of first responders.

Similar to bioskills training courses for surgeons, physicians, and nurses, cadaver training for first responders takes textbook knowledge and translates it into hands-on practice. Listening and watching only takes one so far in their educational advancement. For skills to become fully integrated takes practice. Those who are on the front-lines of medical emergencies have precious minutes in which to make important decisions for their patients. Their skills need to be integrated quickly, preferably before they engage in real-time situations.

Cadaver training for first responders presents the opportunity to practice life-saving interventions such as intubation, chest decompression, emergency tracheotomy, cricothyrotomy, and inter-osteo procedures. These interventions, performed on plastic simulations, provide technical understanding but fall short of enabling the EMT or other professional to fully understand what it is like to work on a human body.

Med Ed Labs is proud to offer cadaver training lab services to paramedics, EMT trainees, fire department personnel, and all other first responders. Hands-on training with a cadaver provides the most realistic experience for healthcare providers. The familiarity with human tissue and internal organs that is gained through cadaver training significantly increases situational awareness during real-life emergencies.

Learn more about our national […]

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    Medical Advancements Providing Hope for Women with Stress Urinary Incontinence

Medical Advancements Providing Hope for Women with Stress Urinary Incontinence

Statistics suggest that, at any given time, approximately 15 million women are affected by stress urinary incontinence. Of the various types of incontinence, this is the most common. Historically, women have had relatively little help in managing this condition. Over time, though, both nonsurgical and surgical solutions have been developed. We’ll briefly outline them here.

Nonsurgical treatment options for stress urinary incontinence have included:

Pelvic floor exercises. Known as Kegel exercises after the physician who developed this technique, pelvic floor exercises work by contracting and releasing the muscles that span the lower pelvic region, which includes the vagina, rectum, and the urethra.
Behavioral modification. Avoiding certain activities may reduce episodes of urine leakage, but this can also decrease quality of life.
Transurethral bulking agents such as collagen have been injected around the urethra to thicken tissue and control urine leakage.
Pessary, a removable device that supports the bladder neck by repositioning the urethra.

Surgical treatment for stress urinary incontinence has generally consisted of mesh techniques, also referred to as “sling” surgery. Mesh techniques became popular due to their minimally invasive nature compared to fascia or donor slings. However, surgical mesh for stress urinary incontinence has had somewhat of a turbulent history that has included numerous cases of complications. Now there is an alternative.
Innovative Technology for the Reduction of Stress Urinary Incontinence
Medical professionals are aware that our industry is constantly changing. New technologies are continually being assessed in stringent clinical trials. Earlier this year, the FDA cleared a new device by BTL Aesthetics, a leader in energy-based devices. This device, Emsella, reportedly tones the pelvic floor without a woman having to perform repetitive exercises. Emsella works via HIFEM®, a patent-protected technology that is already winning awards for its […]

Patient Engagement Improves Overall Satisfaction

Medicine sustains a nearly-constant state of evolution. Every year, new devices and techniques are tested. New products and technologies are presented to the medical community for clinical trials and FDA approval. With the consistent advances in the clinical side of care, providers may overlook the opportunities they have to also improve overall patient satisfaction. Here, we discuss a few ways in which technology is improving patient engagement and how that engagement benefits each patient’s experience with their provider.

More medical offices, clinics, and hospitals are equipping spaces with technology that patients are familiar with. These technologies may be used to educate patients or, sometimes, to provide an entertaining distraction from discomfort and stress. Some of the strategies that are making a big impact on patient engagement at this time include the following.
Entertainment Systems
One of the biggest challenges that nursing and support staff face is helping patients deal with physical discomfort. A patient that is in pain is also dealing with stress, fear, and anxiety. Altogether, unmanaged pain and emotional distress will degrade the patient’s sense of well-being. It may sound simplistic that entertainment systems that interact with the patient could make a difference in state of mind. However, devices such as televisions, mobile devices, and tablets have demonstrated efficacy in distracting patients from their immediate situation. Not only does this distraction ease the load of nursing staff, but it can also enable patients to rest better and heal more quickly.
Doctor Accessibility
Patients feel more satisfied when they know they have access to their doctor. The higher doctor-patient interaction is, the better care the patient feels they receive. Utilizing the same software and technology on which entertainment systems are based, doctors can communicate more readily with their […]

The Role of Spinal Cord Stimulation is Expanding

Spinal cord stimulation (SCS) has been a known therapy for more than 50 years. At this time, approximately 35,000 patients receive an SCS implant each year. This method of pain management may have gained FDA approval in 1989, but since that time, its use has gained popularity among physicians and their patients. We recently discussed the value of spinal cord stimulation as a drug-free therapy. This conversation needs to continue so more patients are able to find relief from pain in a safe and meaningful way.
Ways that Spinal Cord Stimulation is Being Used
Spinal cord stimulation works by delivering mild electrical stimulation to the nerve roots at the spinal column, where pain signals originate. These gentle electrical jolts inhibit the transmission of pain sensation from reaching the brain, thus minimizing or eliminating the pain a patient may otherwise have to medicate.

The primary use of SCS is to treat neuropathic pain, which develops out of nerve damage. The cause of nerve damage matters very little; SCS may manage pain originating in disease, injury, or other factors. Most commonly associated with post-surgical back and leg pain, spinal cord stimulation is expanding to usage in other areas of medicine.

In addition to helping patients who have undergone back surgery, SCS is increasingly being considered as an alternative to back surgery. This is especially so in cases where surgical intervention is not expected to fully resolve the cause of pain. Another common indication for spinal cord stimulation is to treat the symptoms of complex regional pain syndrome. Neuropathic pain related to peripheral nerve damage also responds very well to this modality. This includes instances of diabetes, trauma, viral infection, and other conditions.

Although primarily considered for neuropathic pain, spinal cord stimulation […]

Managing Pain in the Face of an Opioid Crisis

The medical community has long appreciated the value of opioid medications. The poppy plant was first used medicinally in 3400 BC and continued to spread from ancient Mesopotamia and Sumer to the rest of the world. Known for powerful analgesic properties, opioid medication also became synonymous with addition. This is not new. German physician Dr. Eduard Levinstein was the first to describe the downside to the popular opiate Morphine. That was in 1877.

If you practice medicine today, you know that we are in a dire situation when it comes to the use of opioids to treat pain. Patients suffering from chronic pain rely on their physicians for relief. They trust that their physicians know or are trying to discover ways to manage pain; to help them regain an adequate quality of life. The use of opioids is controversial not only for doctors but also for their patients, who may be apprehensive to take a drug for fear of addiction. To that end, pain management continues to be a challenge within the medical community.

At Med Ed Labs, we are committed to the progress of various areas of medicine. Pain management, in the face of the current opioid crisis, is an area of importance. Fortunately, it is an area in which progress is being made. We are proud to be involved in this transition from drug therapies to those that are drug-free. In particular, we offer training in cutting-edge modalities such as non-pharmacologic neuromodulation via spinal cord stimulation (SCS).

Neuromodulation is a nonpharmacologic therapy that suppresses the activity of the nervous system for the treatment of pain. The technique in general, and spinal cord stimulation, in particular, has become an efficient and widely used alternative for physicians […]

Human Cadaver Training and the Issue of Ethics

For years, the use of human and animal models has provided medical students and licensed physicians with invaluable information and education. Cadavers have been used to educate medical students on human anatomy and to enable physicians to observe the body in a way that does not put a patient at risk. Cadaver training is essential to optimal patient outcomes and to the basics of the doctor-patient relationship. Even in light of years of evidence which points to the value of cadaver training, this area of medical education is somewhat controversial.

Alternatives to Cadaver Training

Historically, the alternative to human cadaver dissection and training has been the good old textbook. However, there could be no textbook content if cadaver training had not existed first. Additionally, one cannot know what it looks like or feels like to perform a surgical procedure or even a nonsurgical treatment on live human tissue by reading a textbook.

The more modern approach to teaching anatomical nuances is for students to conduct processes and procedures using virtual reality. Proponents for this way of learning warn of the ethical and safety issues of using human cadavers for bioskill training. We’d like to respond to common theories on these matters.

Ethical Questions Regarding Cadaver Procurement

Some say that there is an obscure industry in which vendors have profited from the sale of cut and intact human tissue for research purposes due to the fact that most states do not have laws against the sale or purchase of body parts. This sounds ominous and dark and is promoted in a way that may call into question the ethics of medical research. Med Ed Labs was established to assist professionals ranging from physicians to support staff to medical sales representatives […]

Cadavers Hold Value in the World of Aesthetic Medicine

A few decades ago, there was no such thing as aesthetic medicine. We had general surgeons, specialists, and plastic surgeons. To regain a more youthful appearance meant seeing a board-certified plastic surgeon for a facelift. Now, we not only have nuanced procedures such as neck lifts, eyelid lifts, and brow lifts but we also have a plethora of nonsurgical modalities from which patients can choose to address specific cosmetic concerns. Hence, the field of aesthetic medicine was born.

Once the development of nonsurgical treatments began, innovation has not stopped. At this time, we are seeing yet another dermal filler on the horizon. In the works by a subsidiary of Silk, Inc., this new filler differs from those that are currently popular in its active ingredient. Where many of the dermal fillers used today have a base ingredient of hyaluronic acid, this new filler, as you may have guessed, is made of silk. According to the developer, the product is made of pure silk protein in an Activated silk suspension.

Why would doctors consider another soft tissue filler option for their patients? Silk, Inc. is banking on values such as comfort, flexibility, and duration. The product’s maker believes that patients may have fewer and less intense side effects from the silk ingredient. Also, like the hyaluronic acid fillers used today, this new filler will provide the flexibility to treat various areas and achieve a range of timeframes for results, from 3 months to 2 years.

Where Cadavers Fit into All of This

Cadavers have been widely used for years in undergraduate and postgraduate educational programs. This method of training is recognized for its relevance to surgeons and other specialists but not so much for the value […]

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