DSA Surgeon Matthew Johnson is a fellowship trained GI & Critical Care physician. Gastrointestinal diseases (GI) refer to diseases involving the gastrointestinal tract, namely the esophagus, stomach, small intestine, large intestine and rectum, and the accessory organs of digestion, the liver, gallbladder, and pancreas.
A next-generation surgical robotic system has been developed in Cambridge, UK. It will be used on NHS patients for the first time in 2019.
The Versius robot seen here was designed and built by CMR Surgical, formed in 2014, whose five founders brought with them global experience across the diverse disciplines of surgery, medical device development, start-ups and commercialisation. In June 2018, the company announced a record-breaking financing round that raised $100m in total, Europe’s largest private Series B medical device funding raise.
CMR’s stated aim is “to make minimal access surgery available to all”, by creating “a paradigm shift in robotic-assisted surgery”. Minimal access surgery (sometimes known as keyhole or minimally invasive surgery) is an alternative to open surgery that was first pioneered around 40 years ago. For patients and healthcare providers alike, the benefits are numerous and compelling – reduced trauma, faster recovery and improved clinical outcomes. For example, the risk of infection from a robotically assisted hysterectomy is reduced by almost a factor of three compared with open surgery (from 6.5% to 2.2%).
There are an estimated six million open surgery procedures each year that could be performed using minimal access surgery. CMR Surgical believes that robotics opens up the potential for millions more people to benefit from laparoscopic surgery.
The Versius machine is a rival to the American da Vinci system. CMR expects to introduce their new robotic system to hospitals within the next six months, beginning in the UK and Europe, then with international expansion shortly afterwards. The $4bn global market for surgical robots is predicted to increase five-fold to reach $20bn by 2024.
“Surgeons will remain in control, but as we develop the human-robot interface there may be simple parts of an operation, such as suturing or closing a wound that may be automated,” said Dr Hachach-Haram, a member of the Royal College of Surgeons’ Commission on the Future of Surgery.
Gastrointestinal surgery is a treatment for diseases of the parts of the body involved in digestion. This includes the esophagus (ee-sof-uh-gus), stomach, small intestine, large intestine, and rectum. It also includes the liver, gallbladder, and pancreas.
Surgery may be used to remove a cancerous or noncancerous growth or damaged part of the body, such as the intestine. It may also be used to repair a problem like a hernia (a hole or weak spot in the wall of the abdomen). Minor surgical procedures are used to screen and diagnose problems of the digestive system.
Endoscopic retrograde cholangiopancreatography, or ERCP, is a procedure to diagnose and treat problems in the liver, gallbladder, bile ducts, and pancreas. It combines X-ray and the use of an endoscope—a long, flexible, lighted tube. Many health problems can partly block a portion of your esophagus.
Neither Christopher Fisher nor most of his crew of trauma surgeons were planning on working on the night of October 1, 2017, the night that Stephen Paddock opened fire on a Route 91 music festival on the Strip, raining hundreds of rounds onto the crowds from his 32nd floor hotel room and ultimately killing 59 people and wounding over 500.
Around 10 p.m., he got a text from the hospital, saying that there may have been a mass casualty.
He says, “About 90% of the time, the mass casualty warnings end up being kind of nothing, minor injuries, so I didn’t think too much of it, but I just got my scrubs back on and I started hearing my trauma pager go off with the first two gunshot wounds and after that I got in my car and headed back.”
Traumatic Injuries and Other Complex Life-Threatening Conditions are Treated Rapidly in Our Level II Trauma Center
Trauma is severe blunt or penetrating injury primarily caused by automobile crashes, gunshots, knife wounds, falls, battery, or burns.
A trauma victim’s care is a critical emergency. When trauma patients arrive at Sunrise Hospital, a team of physicians, nurses and appropriate support staff are already assembled and prepared for rapid assessment and treatment. Emergency physicians and nurses are in-house to initiate resuscitation and stabilization. Surgeons, anesthesiologists, physician specialists, and trauma nurses are on call and promptly available, as well as immediate access to dedicated medical equipment and operating room facilities.
Trauma physicians manage trauma patients during their hospitalization along with a specially trained trauma staff that provides patients with multidisciplinary care throughout hospitalization.
Our Trauma Team includes:
- RNs and Clinical Nurse Specialists
- Respiratory Therapists
- Physician Assistants
- Social and Case Managers
- Pastoral Care
Resources and procedures available to trauma patients may include:
- Cardiothoracic surgery
- Internal medicine or pediatric medicine
- Ophthalmic, maxillofacial and plastic surgery
- Radiological specialties such as ultrasonography, CT scans, MRI
- Neurosurgery: Care for brain and spine injuries by the Neurovascular Intensive Care Unit of The Nevada Neurosciences Institute (NNI) at Sunrise Hospital.
- Rehabilitation: Sunrise Hospital’s Comprehensive Integrated Inpatient Rehabilitation Program is accredited by CARF, indicating our commitment to compliance with international rehabilitation standards of quality. Our RESTORE Wound Specialty Programprovides both adult and pediatric wound care treatments for outpatients.
Level II Trauma Verification Demonstrates Better Patient Outcomes and Saves Lives
We have received the American College of Surgeons’ Level II Trauma verification because we have demonstrated leadership in the treatment of traumatic injuries and other complex life-threatening conditions. As a Level II Trauma Center and regional referral center from other medical facilities, Sunrise Hospital provides advanced tertiary medical services for thousands of patients each year and serves as a lead trauma facility for Southern Nevada while working closely with Nevada’s neighboring states to provide trauma care for those patients who require a higher level of care.
What is robotic surgery? To the uninitiated, it might conjure up images of everything from Star Wars’ beloved character R2-D2 to the Roomba automatic vacuum cleaner. But for Matthew Johnson, MD, it’s just a way of life.
Dr. Matthew Johnson, MD ’05 with the Da Vinci robotic surgery system.
As a board certified robotic surgeon, Dr. Johnson performs surgery using very small tools attached to a robotic arm, which he controls with a computer. The robot follows his hand movements to perform the procedure using the tiny instruments, and a 3-D camera allows him to view enlarged images of the patient’s body throughout the surgery.
The benefits? Tiny, robot-manipulated tools mean greater precision and smaller incisions than traditional open surgery. This results in a host of other positive outcomes: reduced blood loss, quicker healing time, decreased risk of infection, and shortened hospital stays.
“I do about 95 percent of my surgeries robotically now,” said Dr. Johnson, who began using the method about three years ago. “The instruments are so precise. It’s really a great thing.”
Starting a Career in Surgery
A Houston native, Dr. Johnson had wanted to be a physician since he was ve years old. His passion grew from playing doctor with his family to majoring in microbiology at the University of Texas at Austin. The culminating experience was after college, when he joined his father on a business trip to Holland. His father was a lawyer who worked with several Dutch cardiac surgeons, and Dr. Johnson had the opportunity to watch a nine-hour double aortic replacement surgery.
“Once I saw that, I just said, ‘wow, this is it,’” says Dr. Johnson.
Now, more than ever, he knew that surgery was the career for him. But he had a critical obstacle—he wasn’t accepted into the U.S. medical schools he’d applied to. He wasn’t a great test-taker, and his MCAT score didn’t fully reflect his abilities. So he chose to apply to a medical school that looked beyond the numbers: American University of the Caribbean School of Medicine.
“It was incredible,” said Dr. Johnson. “I miss it every single day. And I did my third-year clinical rotations in England—if I had gone to an American medical school, I wouldn’t have been afforded that opportunity. I was able to travel everywhere.”
After graduating from AUC, Dr. Johnson completed his surgery residency at University of Nevada School of Medicine in Las Vegas, where he served as chief resident and earned the Professionalism Award. He stayed at UN as a fellow in the acute care surgery program. UN was the first in the country to develop this fellowship, which combines a year of surgical critical care and a year of acute care surgery.
“It makes you prepared for anything surgical that comes in the hospital. You know you can take care of it,” said Dr. Johnson.
Getting a Patient Back in the Game
Today, Dr. Johnson continues to work out of Las Vegas, where he is associated with several different hospitals. He specializes in gallbladder, hernia and foregut surgery, as well as trauma, general and acute care surgery.
“I can’t imagine myself doing anything else,” he said. “With surgery—especially trauma—you don’t know what’s coming. You know what the books have said and what your training has provided you, but it’s spontaneous. You see the patient and sometimes there’s blood coming out of every orifice and organ there is—you have to know what to do and how to take care of it. It’s fast and furious. You just have to stop the bleeding.”
One of his most memorable experiences was treating a 14-year-old boy with life-threatening injuries to his pancreas, small intestine and colon from a bad hit in a football game. The boy spent a month in the hospital. A year later, he’s made a full recovery and is back on the football field as an All-Star player.
He and Dr. Johnson still keep in contact—in fact, Dr. Johnson cheered him from the stands at a recent game.
“Patients like that really touch my heart,” said Dr. Johnson. “The patient and their whole family are so thankful. And for me, to know that my team and I have saved a life—it means so much.”
No matter the situation, Dr. Johnson prides himself on being a compassionate doctor.
“Spending that extra time and showing compassion often get lost in the workload. I do as much as I can to make sure that doesn’t happen,” said Dr. Johnson. “It’s worth spending that time. I just try to let them know I’m here and that they’re going to be okay.”
What “FACS” Means
The American College of Surgeons is a scientific and educational association of surgeons that was founded in 1913 to improve the quality of care for the surgical patient by setting high standards for surgical education and practice. Members of the American College of Surgeons are referred to as “Fellows.”
Fellow, American College of Surgeons
The letters FACS (Fellow, American College of Surgeons) after a surgeon’s name mean that the surgeon’s education and training, professional qualifications, surgical competence, and ethical conduct have passed a rigorous evaluation, and have been found to be consistent with the high standards established and demanded by the College.
All Fellows are required to have the following qualifications:
Graduation from a medical school acceptable to the American College of Surgeons.
Certification by an American Surgical Specialty Board which is a member of the American Board of Medical Specialties and which is appropriate to the applicant’s specialty practice, or an appropriate specialty certification by the Royal College of Physicians and Surgeons of Canada.
A full and unrestricted license to practice medicine in their respective state or province.
One year of surgical practice after completion of all formal training. Additional practice time may be required if the practice situation and/or geographic location changes. Exceptions may be granted by the Fellowship Liaison Committee.
A current appointment on the surgical staff of the applicant’s primary hospital with no reportable action pending which could adversely affect staff privileges at that or any other health care facility.
A current practice that establishes the applicant as a specialist in surgery. The degree to which a practice must be restricted to the specialty is to be determined by a responsible College Credentials Committee. The limitation of an applicant’s practice to the scope of the designated specialty is an important consideration.
Interest in pursuing professional excellence both as an individual surgeon and a member of the surgical community. Such interest may be evidenced by membership in local, regional, and national surgical specialty societies; participation in teaching programs and on hospital committees; continuing medical education through attendance at professional meetings, courses, and seminars.
Ethical fitness as well as professional proficiency as determined by an appropriate College Credentials Committee. This determination is based upon information obtained from Fellows who were consulted as references and from other sources.