Watch a video about the aquablation therapy used by L. Faith Payne here.
Urologist L. Faith Payne, D.O., FACOS, a West Virginia School of Osteopathic Medicine (WVSOM) 2007 graduate, is one of the few physicians who have been able to get their hands on medical equipment that reduces not only operating time, but also recovery time and side effects.
The technology is called aquablation therapy and uses a real-time, ultrasound-guided, robotic-assisted and heat-free waterjet to treat benign prostatic hyperplasia — also known as enlarged prostate — a health issue that is common as men age. It combines ultrasound imaging with a thin camera, called a cystoscope, to allow surgeons to see the entire prostate as they target the tissue to be removed.
Payne practices at Raleigh General Hospital in Beckley, W.Va., and is the only urologist in the southeastern part of the state who has the nearly $1 million equipment at her surgical fingertips. She’s been utilizing it in her operating room since the beginning of summer, and she said it significantly reduces the time spent in the operating room.
“I just did a procedure on a patient with 160 grams of prostate and the total ablation time was 9 minutes,” Payne said. “This would traditionally take well over an hour using the traditional TURP [transurethral resection of the prostate] method. The amount of time a patient is under anesthesia is significantly reduced. It’s good for the patient and it’s also good for the surgeon and the OR team because we can be more efficient.”
Payne and Raleigh General Hospital were identified by LifePoint — a nationwide health care network focused on implementing cutting-edge ideas, partnerships and technology — as one of the busier urology practices. Four hospitals in the country were selected to receive the robotic aquablation system, which has been recognized by the American Urological Association as a standard of care option for minimally invasive surgical treatment for the prostate. Its low side effect profile and long-term success rate makes it technology urologists hope to have.
“We’ve had this for five months, and today we will top more than 30 patients who have been treated with aquablation. I’m keeping live data to compare it with other surgical procedures I perform and that are performed across the country to keep track of how patients are doing post-op and the side effect profile,” Payne said. “In surgery, what matters are the side effects and long-term retreatment rate. In terms of acute complications, we’re just not seeing those like we have with other procedures.”
Another benefit compared to other procedures is that it can be performed on larger prostates. In the past, a TURP procedure has proven to be the most effective for treating an enlarged prostate, but patients can experience side effects like retrograde ejaculation, when fluid goes into the bladder instead of out of the penis during an orgasm.
A 75-year-old Raleigh County man was one of Payne’s first patients to undergo the aquablation therapy at Raleigh General Hospital. He said he had been having difficulty urinating for a while and was looking forward to a minimally invasive surgery.
“I’ve been to a lot of doctors in my life, but she [Payne] was Johnny-on-the-spot … you can’t get any better than that,” he said. “When this came out I think I was the second one to have the procedure, and it has made a 100% difference in my life.”
Payne said other patients have also shown successful results.
“I had a handful of patients who could not void prior to surgery who had catheters and now they are spontaneously voiding. We don’t see a high level of urgency and frequency like we do with other procedures. With such little heat being used, the irritation is significantly reduced,” she said.
SECURING THE TECHNOLOGY
While many hospitals budget for high-priced medical equipment, they may not always be able to secure it. Receiving it for free can be a physician’s dream. Once the equipment was secured, Payne began training so she could incorporate it during surgery.
Brian Hinson, a senior aquablation sales representative with Procept BioRobotics, ensures surgeons are familiar with aquablation technology during surgical procedures and supports patient education. He said Payne is an example of a surgeon who has maximized the benefits of using the technology and has devoted time in getting it to Raleigh General Hospital.
“Dr. Payne has invested a lot of time upfront. She flew to New York and did a case observation with one of our key opinion leaders and watched about five cases. She spent two hours going through online learning modules to she could better understand the technology. She also spent two days in the operating room performing hands-on training so when it came to the first patient she performed this procedure on, it wasn’t the first time she touched the equipment,” he said.
Once Payne has completed 50 aquablation cases she plans to return to New York to review data and evaluate response rates.
While the equipment is dedicated to Raleigh General Hospital, Payne said her goal is to secure one in her outpatient surgery center that is also part of the hospital system.
“Most patients can go home the same day, but if their prostate is larger than 100 grams, they may require 24 hour monitoring due to the need for bladder irrigation or advanced nursing care they otherwise would not receive at home. Those patients will have surgery in the hospital,” she said. “But I have a huge number of patients that fit the criteria for outpatient surgery.”
She currently has 40-50 patients waiting for aquablation therapy.
RAISING AWARENESS
Payne is working hard to make her hospital a center of excellence in urology not only in the area, but in the state.
“I want to put southern West Virginia on the map,” she said. “We are on our way to getting that with aquablation. I want patients to know they can get high-quality, innovative care here in southern West Virginia and they don’t have to travel to another state for surgeries.”
The surgeon also credits her alma mater for the medical education she received in becoming a successful physician who chose to serve patients in West Virginia. She is a testament that WVSOM graduates don’t have to go far to find fulfillment in subspecialties.
“WVSOM prepared me with the medical knowledge to be extremely competitive academically at the national level. My success as a female urological surgeon began there and I can’t be more proud to say I’m an alumni of WVSOM,” she said. “The key to being a successful surgeon is a solid foundation in the fundamentals of primary care medicine.”
September is Prostate Cancer Awareness Month in the U.S. Payne said that with one man being diagnosed with prostate cancer every two minutes in the U.S., it is the most common cancer in men behind skin cancer.
“Screening protocols have been established to diagnose and treat clinically significant prostate cancer,” she said. “This is simple to do and important to prevent unnecessary death or loss of quality of life.”