The cutting edge. It means to be on the forefront, to take the lead.

In the Midwest, we are not always on the cutting edge with the latest fashions or the newest gadgets.

But when it comes to medical technology, not only is Stark County on the cutting edge, it is sharpening the blade.

Back in the mid-1800s, doctors probably thought we could never top the amazing new invention called the X-ray.

Who could have imagined that in 2009, doctors could use robotic arms to perform intricate surgeries or that wounds could be healed in hyperbaric chambers.

Although the heart-lung bypass machine, invented in 1939, allowed doctors to perform open heart surgeries to replace valves and perform bypasses, it would have seemed like science fiction for them to imagine doctors in 2009 performing that same surgery with small incisions that allow patients to go home in two days and return to work in a week.

And when it comes to record keeping, computer and cell phone technology, and innovations in communications and coordination of care, science in the medical field is, at the very least, quite astonishing.

Take a look at what’s happening locally.

AFFINITY MEDICAL CENTER

Affinity Medical Center’s new Heart Center features advanced technology for comprehensive heart care in Western Stark County.

“In the event of a heart attack, getting help quickly can not only save your life, it can also save the quality of your life,” said Ron Bierman, chief executive officer of Affinity Medical Center. “That’s why getting to the closest facility that offers timely cardiac intervention is the very best option for heart patients. Western Stark County will absolutely benefit from having access to comprehensive cardiac care close to home when seconds are critical.”

Affinity opened the new 15,000-square-foot Heart Center in April after months of investigating the feasibility of the project.

“The goal of the program is to provide the very best in cardiac care,” Bierman said. “We’ve developed a top-notch program with an exceptional team of physicians, both cardiologists and cardiovascular surgeons, and experienced nurses and allied health professionals. In addition, we’ve constructed our center to achieve maximum patient outcomes and have equipped our facility with state-of-the-art technology.”

Dr. Antonios Chryssos is the center’s director. The hospital used input from Chryssos and the rest of the cardiac team at Affinity to help build the advanced cardiovascular program.

Chryssos has nearly 5,000 open heart surgeries under his belt. His focus now is on minimally invasive heart surgery, which he performs with the same trained team every time.

Minimally invasive coronary bypass is done while the heart still is beating, Chryssos said. A heart-lung machine is not used.

“We have the ability to bypass four arteries in the heart with this approach,” Chryssos explained.

It uses a combination of small holes or ports in the chest, and a small incision is made directly over the coronary artery to be bypassed. The advantage to this, Chryssos said, is that the patient can be home in two days and back to work quickly.

With a conventional incision, recovery may take four weeks, and the patient isn’t able to return to work for at least six weeks.

Chryssos said he does need to use a heart-lung machine to stop the heart for minimally invasive valve surgery. Again, though, just a small incision is used to replace or repair the valve and surgeons do not have to cut the breastbone.

“It still hurts, but you don’t lose use of your arms for four to six weeks afterwards,” Chryssos said.

ALLIANCE COMMUNITY HOSPITAL

The Wound Care Program at Alliance Community Hospital is having phenomenal success rates in treating chronic, nonhealing wounds.

Program director Melissa Loudon said the facility has an average healing rate of 35 days, which is

20 days fewer than the national average.

She said patients with chronic wounds often have underlying medical conditions that keep them from healing as quickly as most people’s wounds would.

She credits the hospital’s coordination of care with the program’s success.

Controlling diabetes and nutritional problems, among other issues, means the wound can be treated faster.

“Chronic wounds can be of mixed (cause),” said Karen Walker-Albright, a wound care nurse at Alliance. “That means that while their wound can be influenced by diabetic condition, it can also have a component related to incompetent veins or arteries.”

She said those problems can include many things, including high blood pressure, restless leg syndrome, unexplained leg pain, spider veins, lymphedema and obesity.

“Left untreated, venous insufficiency causes a progressive syndrome involving pain, swelling, skin changes and eventual tissue breakdown,” Walker-Albright said.

The hospital’s program also includes home health care nurses so that patients are monitored more efficiently.

Advanced treatments at Alliance include debridement, a surgical procedure that helps to clean the wound and then slightly re-injure it to restart the healing process. Sometimes, wounds whose healing has stalled can be fooled into restarting the healing. The hospital also is healing chronic wounds with skin grafts done with human skin grown in a lab.

Advances in wound care dressing now allow bandages to be customized to treat specific types of wounds. Silver and collagen bandages are two examples, Loudon said.

In addition, about 10 percent of wound patients at Alliance will use hyperbaric oxygen treatments, in which 100 percent oxygen is delivered to the wound in a hyperbaric chamber.

Loudon said chronic wounds are increasing as the population ages, along with growing obesity rates and diabetes.

“We’re not just treating the hole in the patient, but the whole patient,” she said. “It’s corny, but true to our success.”

AULTMAN HOSPITAL

Technology is changing the way that even the tiniest patients are cared for in Aultman Hospital’s new Bedford Building.

Named the “2010 Project” as it was constructed, the Bedford Building is a showcase of medical, information and communications technology. It houses the Emergency Department, Heart Center, Inpatient Pharmacy, Birth Center and Newborn Intensive Care Unit (NICU).

Aultman has the only Level III NICU in the county, which means it is suited to care for babies at all levels of prematurity and those who are critically ill or require surgical intervention. Babies born with serious medical conditions elsewhere are transferred to Aultman for advanced care.

Neonatologists, nurses and nurse practitioners, respiratory therapists and nutritionists staff the facility. They are specially trained to care for premature and medically fragile infants.

Dr. Michael Krew, a maternal-fetal medicine specialist, explained that the NICU at Aultman uses a special team approach.

Members of the OB Stat Team, including the in-house obstetrician, anesthesiologist and neonatal team, are called simultaneously in an emergency, and “any member of the team can make the call when a baby or mom is in trouble,” Krew said.

Unit director Jaime Mosnot said Aultman has one of the few facilities in the country with private patient rooms, offering privacy to parents as they go through a difficult and highly emotional time.

Technology throughout the Bedford Building makes patient-information sharing quick and practical. Each room has its own flat-screen computer where data is entered and viewed by staff. Using security codes, staff members can view patient records, test results, vital signs and more from any station. That means they no longer wait for results to come or for charts to be returned to the end of the bed.

Neonatologist Dr. Roger Vazquez said doctors can obtain the specific information about a patient’s status very quickly.

“Each physician group set up what they wanted to see on their screens,” he explained.

Wireless phones carried by all staff members transmit changes in vital signs and allow them to monitor patients wherever they are working.

Technological safety measures help to ensure medication mistakes don’t happen. Wristbands on the babies are scanned electronically by the nurse, along with the medication. Dosage amounts, times and other data important to the patient are automatically documented, and the information is added to the patient’s electronic chart.

MERCY MEDICAL CENTER

It may be surprising to hear that robots are performing surgeries at Mercy Medical Center.

More accurately, doctors are performing surgeries using the cutting-edge technology of the da Vinci Surgical System.

Cutting edge, indeed. The robot makes small incisions that are used to introduce miniaturized instruments and a high-definition 3-D camera. The surgeon sits away from the patient at a console, where he or she views a magnified, high-resolution 3-D image of the surgical site.

The robot translates the surgeon’s hand movements into precise micro-movements of the da Vinci instruments. The robot’s computer and robotic technologies combine to provide surgeons with improved dexterity, visual depth perception, camera stability and ergonomics.

Dr. Steven Ochs, a urologist at Mercy, has embraced the technology and routinely uses the robot to perform prostatectomies, during which he removes cancer from the prostate gland, and kidney cancer surgeries, as well.

“In simple terms, it’s not as invasive, it uses small puncture wounds, and recovery is very quick,” he said.

In addition, there is less trauma to the body, meaning less pain, less blood loss, and less discomfort later, along with shorter hospital stays and a high probability of preserving sexual function and urinary control.

Ochs, one of the surgeons who helped bring the technology to Mercy, now teaches others to use the robot. He said other specialties, such as cardiology and gynecology, are using da Vinci with great results as well.

For patients undergoing a hysterectomy, a procedure often involving significant pain and a long recovery process, the da Vinci can operate through tiny 1- to 2-cm incisions. Many patients go home the following day — and require no pain medication.

“We are fortunate to be at a community hospital with two da Vinci robots,” Ochs said.

Mercy has two digital operating rooms with voice-activated, hands-free controls, multiformat image monitoring, and audiovisual networking systems.

“Other specialties will find uses for the robot,” said Tom Cecconi, president and chief executive officer of Mercy. “We’re trying to be on the forefront of that. When we saw that the results are as good or better than we expected, we picked up a second (da Vinci) quickly.”

Each one cost $1.6 million, by the way.

“We now have three teams with a solid understanding and expertise in the equipment,” Cecconi said.