Assuta Ashdod: Leading the world of medical innovation

Samson Assuta Ashdod University Hospital hit the ground running when it opened its doors in 2017 and quickly established itself as a center of state-of-the-art medical care and technology, and a place of scientific and medical innovation.

Before it began receiving patients, residents of Ashdod and the surrounding areas were forced to travel to Rehovot – nearly 25 kilometers away – for basic hospital attention and care. But now, over half a million people in the booming Ashdod area can access state-of-the-art medical facilities at a hospital close to home.

Assuta Ashdod also offers a holistic approach to care that is unavailable in the public sector, with an emphasis on a patient’s medical, emotional and social needs. And as the first Israeli “green hospital,” Assuta Ashdod places environmental responsibility at the forefront of its programs and facilities.

It is also a center for medical innovation, with a unique medical accelerator program that is spearheading world-class educational, research and training initiatives.

A leader in surgical innovation

Hundreds of different operations, all using the most advanced equipment available, are performed under the care of Assuta Ashdod. One such surgery, an innovative laparoscopic surgery technique, was pioneered by Assuta Ashdod pediatric surgeon Dr. Vadim Kapuler.

Laparoscopic surgery, also referred to as keyhole surgery, is a procedure that allows a surgeon to access the patient’s stomach or pelvis without intrusive and large incisions. It usually involves making three incisions to the patient’s abdomen, through which a small tube with a light source and a camera is inserted, which allows images to be relayed to the surgeons via a screen.

As a pediatric surgeon, Kapuler was dissatisfied with the traditional method of performing laparoscopies on children, as they were less safe and more uncomfortable. Subsequently, he worked to develop a new method, which he has taught to numerous doctors and surgeons across Israel, changing the landscape of pediatric surgery as a result.

Instead of the traditional three incisions that are required for laparoscopic surgery in most instances, children undergoing laparoscopic surgery under Kapuler, or under any of the surgeons he has trained, have just one incision made, in the navel.

“In children, the navel is extremely close to all of the abdominal organs, and the distance to them is extremely short,” he explained, describing the surgery.

“I have a special tool that allows me, through the same incision, to both see the surgery site with a camera and then, in the same incision, I can insert another tool that allows me to latch onto the organ and remove it [partially or in its entirety] from the abdomen.”

This method has several benefits, he explained. First, it allows for an easier recovery period, as the only incision made is a small one inside the navel, instead of the multiple incisions that would usually be made. This also means that later in life the scar is much less noticeable, which, although a minor issue, can be important to the person who has undergone surgery.

Kapuler performs this surgery for a variety of different needs, all on infants, children and teens. One such instance in which he performs the surgery is for newborns with colonic atresia – a condition that develops before birth in which blood supply to the unborn baby’s intestines is unexpectedly interrupted, causing an obstruction in the large intestine or colon.

Kapuler’s method is also used for children suffering from appendicitis – the inflammation of the appendix. Laparoscopic surgery is the easiest method of removing an inflamed appendix, and by removing the appendix through an incision in the navel, the process is made even less complicated.

Other examples of laparoscopic surgeries performed using the single-incision method include bowel resection and anastomosis (a surgical connection between two structures such as blood vessels or a loop of intestine), segmental resection of the colon, detorsion of the ovary (untwisting of a twisted ovary), and the removal of the colon.

Kapuler’s passion for his work is evident as he talks. He explains how he worked to develop his surgical method, teaching it to countless medical teams – where he used to work, at Hadassah University Medical Center, and now at Assuta Ashdod.

He doesn’t just train doctors in Israel; he has traveled to other countries, including Uzbekistan, Ukraine, Georgia and Kazakhstan, voluntarily taking on the job of training medical professionals in those countries, enabling them to use his techniques and methods in their own work.

“There is nothing more exciting to me than pediatric surgery,” he tells the Magazine. When you operate on someone, usually you may extend their life. But when you operate on a child, you are giving them a chance to live a whole life.”

Surgery with the aid of robots

Prof. Michael Drexler, head of the Assuta Ashdod orthopedics department, is also no stranger to using innovative technology to assist him in his work as one of Israel’s leading robotic joint replacement surgeons.

Robotic joint replacement is an advanced method of performing surgery, in which the surgeon uses a robotic arm to assist in the operation, allowing for more accurate results and reduced room for risk. At the start of the surgery, an initial surgical plan is mapped out on the robot itself, and with this, the surgeon is able to pinpoint the optimal placement of the necessary inserts.

Then, using CT scans and 3D imaging, the robotic device is able to assist in a number of areas, using its advanced navigation system to make as precise a cut as possible, causing minimal damage to the bone and the surrounding tissue. Using a robotic arm eliminates the risk of human error, as it cannot deviate from the path mapped out for it.

This technology has been available since the early 2000s, but only about two years ago did it arrive in Israel, Drexler notes, adding that he was one of the first surgeons in Israel trained to use it.

“This is the future,” he says, explaining the benefits of integrating the use of robotics into traditional surgery. “The robot assists me in the surgery. It allows me to perform surgery in a much more precise way, and this impacts everything – the recovery time of the surgery site, the size of the incision; it allows me to do things much more precisely, and the patient’s body feels better for it.”

Robotic joint replacement surgery has proven to have many benefits, one of the most significant ones being the reduced recovery time. As explained by Drexler, the less impact there is to the bone and tissue, the faster the recovery time is. Whereas traditional full knee replacement surgery has a recovery time of four to six weeks, studies have shown that when this surgery is carried out with the help of robotics equipment, recovery time can be halved.

“This technology is really innovative, and its use in joints and orthopedics is something that only recently came onto the scene. It’s a field that is only expanding,” he concludes. “Now there are robots that work on the spine, on the shoulder... Robots will be central players in the precise work that we do; the robots make it a possibility.” ■

This article was written in cooperation with Assuta Ashdod University Hospital.