Ads for Bedford Ambulatory Surgical Center in Bedford, NH

BASC maintains position as leader in outpatient surgeries This summer, Bedford Ambulatory Surgical Center (BASC) has added a powerful new tool to its orthopedic suite: endoscopic spine surgery. By using an endoscope–a small, flexible, lighted camera–surgeons can repair spine damage with smaller incisions and minimal disturbance to nearby tissue. For more than 30 years BASC has been known for its pioneering outpatient orthopedic innovation. “We have had a history of leading the way orthopedically,” said BASC CEO Nick Vailas. “We were the first to do an outpatient rotator cuff, first to do outpatient total joint replacement and outpatient anterior cruciate ligament repairs (in New Hampshire).” Adopting proven new technologies has allowed BASC surgeons to expand on the offerings of outpatient procedures, ultimately saving patients time and money. Investing in this technology is a testament to BASC’s commitment to cutting-edge, patient-centered care. Introducing endoscopic spine surgery Spine surgeon Dr. Matthew Wilkening led the effort to adopt this technology at the practice. The endoscope provides light and visuals with just a one-centimeter incision, instead of a surgeon having to open the area wide enough to see with their eyes alone. The endoscope’s flexible nature also means it can curve around the spine, providing a visual that would be practically impossible otherwise. “In this situation, I can actually put the camera right into the area where the disc is herniated,” Dr. Wilkening said. “Therefore, I have a much smaller amount of what we call dissection, or surgical approach.” Endoscopic spine surgery brings smaller incisions, faster recovery time to patients In the two months that Dr. Wilkening has been using the technology at BASC, its primary role has been as a tool in endoscopic discectomy, where part of a herniated disc is removed to reduce pressure on compressed nerves. “This is a surgery that has been around for a few years in a variety of forms,” Dr. Wilkening said. “However, I waited until I saw a company with a cohesive training approach, before I started doing these in real living patients.” Compared to traditional approaches, the procedure involves less tissue disruption, quicker recovery, and may avoid more invasive options like spinal fusions in certain patients. The benefits of outpatient spine surgery For patients, and often their employers providing insurance coverage, how quickly you can return to activities is a key factor in where you get care. “I have had patients who are out running errands two days after surgery,” said Dr. Wilkening. “The recovery is very quick.” While the pain from surgery is usually gone in just a few days, it does still take the same amount of time for the disc itself to heal, with moderate restrictions for two to three months, Dr. Wilkening said. “Each of my patients has been distinctly impressed with the relative lack of pain that they’ve had from the surgery, and the significant improvement symptoms that they’ve had,” he said. While the minimally invasive nature of the procedure may reduce infection rates, there is limited data so far due to the technology’s relative novelty. Dr. Wilkening sees wider applications for technology as well, beyond the procedures he’s currently using it for. “I don’t think we know where the limits are of this technology, because it is new enough, and because it is really only used in a few places,” he said. “I’m optimistic that the ceiling for what we can do with this technology, what we can help our patients with and how we can make their outcomes better with less surgical pain, is extremely high.” He added that it might even provide surgery as an option for patients considered too old or not healthy enough to risk a more invasive procedure. Driving lower-cost, high-quality care forward Access, affordability and quality are central to all the work that BASC does, which is in part fueled by its physician owners. “We don’t have a bureaucracy,” Vailas said. “Our board meets monthly, and we approve things or don’t approve them, and it’s literally a physician-driven enterprise. Oftentimes it isn’t just a bottom-line decision, it’s what’s in the best interest of patient care.” With this sort of organizational structure, BASC can act nimbly to incorporate new technologies. Vailas said it only took about three to four months to implement Wilkening’s proposal for endoscopic spine surgery. Wilkening said that for physicians who can provide evidence that a new approach is effective, BASC is usually open to allowing it. “When you have other physicians, your peers, be the ones guiding the decision making, we usually come up with the right answer,” Vailas said. Expediency backed by evidence is key for BASC in providing the health care people need, whether that’s getting better technology in the operating room or speeding up recovery time. “When you are a facility that prides itself in sports medicine and occupational medicine, time is of the essence,” Vailas said. “Time is not a big issue or is not a concern for health insurance companies, but if you’re an injured worker, every day you’re out of work makes a huge difference in your life.” BASC remains committed to leading outpatient surgical innovation in the state with the addition of endoscopic spine surgery and other minimally invasive procedures, such as robotic-assisted joint replacements. To learn more about BASC’s leading orthopedic offerings, visit bascnh.com. 11 Washington Place, Bedford, NH 03110 • 603-622-3670 • bascnh.com