Dr. Suzanne Merrill
speaker
74 appearances
1 recordings
1 series
first heard Aug 2024
last heard Aug 2024
Dr. Suzanne Merrill’s voice in public audio — every appearance, attributed to the second.
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But that white light visualization should not be infringed upon because of that you know, optical imaging agent in there.
Yeah, no, I think it's really important just to, you know, lose the headache of something which has to be done before, right, you can do surgery on a patient and right before in that pre-op setting. So I think one, you know, for all our listeners, PhotoCure creates a kit, a SysView kit, and really it has everything in there to mix and instill, okay?
You do have to provide a separate, or we provide a separate catheter and Eurojet, But everything is in that SysView kit to use in terms of mixing up, et cetera. And so ultimately, we have created kind of a pre-op order form for our nurses. And we had a full run through in pre-op, kind of a learning session before we kind of rolled this out. at my hospital that I work at. And that has worked well.
And so ultimately, the orders get sent and the nurses now know what to do. The consent is already signed before that patient walks into pre-op. So the nurses have no reason by which to carry out your orders going forward. And ultimately, you know, one of the first questions they ask the patient is, you know, can you hold your bladder, you know, for 30 minutes to an hour?
And if they can, then likely we do not leave a catheter in them clamped. We remove it and they hold it. You really want a 60 minute dwell time post installation for the imaging agent to work well. And you don't want to exceed three hours either. And so because there's at least, you know, about 30 minutes of time, you know, to install.
get the patient and put this drug in, if you will, everything like that. And then you got 60 minutes of dwell time. Sometimes this does not work best as the first case. So something to think about, or you at least allocate your patient flow to maybe come in a little bit earlier. So you can start on time.
But then actually stacking these cases, I think, works pretty nicely, gets the nurses into a rhythm in the pre-op area. But ultimately, once the patient has dwelled for that amount of time, then they come back to the OR, you put your scope in. The scopes, again, that we use with SysView are stored scopes. OK, that has the blue light capability. So that's really important.
So your hospital needs to be outfitted with Storz equipment. This cannot be used with Olympus.
That's correct. And I think we can certainly should talk about this some more in that this, I think for, you know, a lot of providers, a lot of groups out there, again, academic centers, you know, has this been kind of one of the, you know, barriers that's felt when thinking about can I, should I incorporate this technology into
into our practice is because if they don't already have Storz equipment, it can be an upfront cost. Can you get into a contract, of course, where you don't have to buy all this equipment upfront? And I will tell you, even nowadays, there are companies that you outsource for lasers, for example.
These companies are buying this equipment and are going to soon be providing this option just like they do the Thulium laser, for example, to different ASCs or hospitals, et cetera, that do not want to buy this equipment outright. So it is going to become more accessible for hospital systems, again, groups that don't want to invest at the outright.
Not that not that I know of. It's interesting.
Yeah, it really it really is. And I think where why these kind of, you know, third party, you know, groups are, you know, again, purchasing this equipment and again, being offering it is because. Actually, patients are now seeking out this technology. I think it's been around for some time. The evidence is backing it. It's now in our guidelines. More providers are using it. The word's getting out.
It's on or kind of been talked about, described on kind of more national platform organizations that are patient-facing. And so... again, patients are seeking it out.
So I think these companies are getting savvy that they know that it's going to be a used technology and they're going to fit a need where, again, groups might not want to be buying it outright, but they'll use it just like they do these high-priced lasers.
Then you can leave that catheter clamped. No problem. Just like you do for, you know, our intervesical therapy patients who can't hold their bladder. You can always, you know, leave that catheter in, balloon, you know, balloon up. catheter clamped or a plug and it works just well.
So that really is a very important question to have your pre-op nurses ask because certainly you don't want to, again, use this drug, put it in, and then the poor patient has to go to the bathroom the next 15 minutes.
Yeah, no, good question. No, there's not. And I think an important point to make that these pivotal studies revealed is that there really wasn't a difference in side effects that patients had who had undergone cyst view installation, blue light illumination. compared to those patients who just underwent the white light TRBT.
And another important tidbit to know is, too, that you can certainly still use, I have done it, post-op gemcitabine for patients who you feel that that is still indicated on. You can perform retrograde pylograms. So all that stuff you can still do, really. You can carry out your normal, again, interoperative workflow for that patient as it's dictated by their situation.
Another important point is if you're doing this after you've done intervesical induction therapy in a patient, you do want to wait about that six-week kind of time point as shortening it up, certainly taking them back too soon after intervesical therapy and using blue light. That's where you probably can see more false positives happen.
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