1 00:00:00,080 --> 00:00:02,319 Hi, everyone. This is Lucas Voss with Becker's 2 00:00:02,319 --> 00:00:04,080 Healthcare. Thanks so much for tuning in to 3 00:00:04,080 --> 00:00:06,480 the Becker's Healthcare podcast series. It's great to 4 00:00:06,480 --> 00:00:09,119 have you today. Excited and thrilled to be 5 00:00:09,119 --> 00:00:11,599 back for part two of our series with 6 00:00:11,599 --> 00:00:14,559 doctor Aaron Chamberlin, a board certified orthopedic surgeon 7 00:00:14,559 --> 00:00:17,414 with the Intermountain Orthopedic Specialty Group. And I'm 8 00:00:17,414 --> 00:00:20,155 excited to continue our conversation around the evolution 9 00:00:20,214 --> 00:00:22,935 of shoulder surgery today and also dive in 10 00:00:22,935 --> 00:00:25,734 on advancing shoulder care with the enhanced intact 11 00:00:25,734 --> 00:00:28,214 tissue sparing surgical technique. We'll hear a little 12 00:00:28,214 --> 00:00:30,454 bit more about that here in just a 13 00:00:30,454 --> 00:00:31,675 little bit. Doctor Chamberlaine, 14 00:00:32,190 --> 00:00:33,789 great to have you again. Thanks for being 15 00:00:33,789 --> 00:00:34,289 back. 16 00:00:34,670 --> 00:00:36,109 Thank you. Good to good to see you. 17 00:00:36,109 --> 00:00:37,630 Good to be with you again, Lucas. Yeah. 18 00:00:37,630 --> 00:00:39,950 Absolutely. Excited to dive into a little bit 19 00:00:39,950 --> 00:00:43,010 more detail from our first conversation here. 20 00:00:43,549 --> 00:00:45,710 We've seen a lot of attempts over the 21 00:00:45,710 --> 00:00:47,570 last couple of years to develop a 22 00:00:48,155 --> 00:00:48,655 successful 23 00:00:49,274 --> 00:00:51,375 subscap sparing approach, really. 24 00:00:51,755 --> 00:00:55,034 What has your experience been with these previous 25 00:00:55,034 --> 00:00:57,534 techniques? Where is this space at now? 26 00:00:58,234 --> 00:01:00,395 Yeah. So I I first, 27 00:01:01,160 --> 00:01:03,240 explored the idea of subscap sparing many, many 28 00:01:03,240 --> 00:01:05,319 years ago in an attempt to try to 29 00:01:05,319 --> 00:01:06,939 help some of my patients where, 30 00:01:08,120 --> 00:01:09,819 their ability to heal a subscapularis 31 00:01:10,280 --> 00:01:12,760 repair would be is diminished due to some 32 00:01:12,760 --> 00:01:14,380 patient comorbidities or immune 33 00:01:14,825 --> 00:01:18,344 system deficiencies or medication management. So where I 34 00:01:18,424 --> 00:01:21,784 I'd explored historically with historical implants, the subscap 35 00:01:21,784 --> 00:01:24,744 sparing approach, which largely involved using a stem 36 00:01:24,744 --> 00:01:25,244 implant 37 00:01:25,704 --> 00:01:28,045 and then, you know, trying to 38 00:01:28,424 --> 00:01:29,564 do our best to 39 00:01:29,969 --> 00:01:31,969 execute some of the steps along the way, 40 00:01:31,969 --> 00:01:32,469 which 41 00:01:32,770 --> 00:01:34,310 without appropriate instrumentation, 42 00:01:34,689 --> 00:01:36,689 it just it was very time inefficient. It 43 00:01:36,689 --> 00:01:38,950 was extra time under anesthesia for the patient. 44 00:01:39,170 --> 00:01:41,090 Required a lot of extra steps to try 45 00:01:41,090 --> 00:01:44,015 to verify that what I was doing intraoperatively 46 00:01:44,234 --> 00:01:44,734 was, 47 00:01:45,194 --> 00:01:47,195 you know, exactly what I'd planned and intended 48 00:01:47,195 --> 00:01:49,194 to do from a surgical technique standpoint. We 49 00:01:49,194 --> 00:01:50,255 would never wanna compromise 50 00:01:50,715 --> 00:01:52,715 an outcome just to try a technique. And 51 00:01:52,715 --> 00:01:55,694 so, double and triple checking everything with historical, 52 00:01:56,500 --> 00:01:58,900 just implants and lack of instrumentation just took 53 00:01:58,900 --> 00:02:00,359 us quite a bit longer. 54 00:02:00,819 --> 00:02:02,979 What I've seen evolve and what we've done 55 00:02:02,979 --> 00:02:03,799 with the, 56 00:02:04,500 --> 00:02:06,359 the new evolution and intact, 57 00:02:07,060 --> 00:02:10,314 enhanced subscap sparing tissue sparing technique If we 58 00:02:10,314 --> 00:02:12,574 try to address the steps that really, 59 00:02:13,275 --> 00:02:15,694 we needed some extra aids to help us 60 00:02:16,314 --> 00:02:18,074 navigate and execute some of the steps, some 61 00:02:18,074 --> 00:02:19,275 of the key steps in the in the 62 00:02:19,275 --> 00:02:22,394 shoulder replacement, specifically the humeral head cut where 63 00:02:22,394 --> 00:02:24,919 we're not able to completely visualize and see 64 00:02:24,919 --> 00:02:27,419 the humeral head. We're able to use instruments, 65 00:02:27,879 --> 00:02:30,539 to, more quickly and efficiently and accurately 66 00:02:31,080 --> 00:02:33,719 perform that step. The other thing that's changed 67 00:02:33,719 --> 00:02:36,139 is is, you know, we've we've now, 68 00:02:36,925 --> 00:02:39,745 migrated as a profession largely to stemless implants. 69 00:02:40,044 --> 00:02:41,965 And so that changes the technique a little 70 00:02:41,965 --> 00:02:43,025 bit from historical, 71 00:02:43,724 --> 00:02:45,085 where we would use the stem and the 72 00:02:45,085 --> 00:02:49,245 intramedullary canal for alignment. Now the, the stemless 73 00:02:49,245 --> 00:02:49,745 implant 74 00:02:50,125 --> 00:02:52,260 can be placed in a variety of locations, 75 00:02:53,200 --> 00:02:55,700 which can add flexibility, but also, 76 00:02:56,159 --> 00:02:58,639 adds some variation potential, which in in a 77 00:02:58,639 --> 00:03:00,419 negative way where we wanna be reproducible. 78 00:03:00,800 --> 00:03:02,099 And so adding instrumentation 79 00:03:02,719 --> 00:03:06,000 and developing instrumentation help, be reproducible and accurate, 80 00:03:06,000 --> 00:03:07,544 and that is has been a a very 81 00:03:07,544 --> 00:03:10,044 positive evolution from from where we were historically. 82 00:03:10,824 --> 00:03:13,245 Now you are an innovator by passion, 83 00:03:14,104 --> 00:03:16,504 but also by trade. You've been part of 84 00:03:16,504 --> 00:03:17,164 the development 85 00:03:17,625 --> 00:03:19,465 of Intact. You were very involved in in 86 00:03:19,465 --> 00:03:20,925 the development of it itself. 87 00:03:21,379 --> 00:03:23,699 What sets it apart right now from other 88 00:03:23,699 --> 00:03:25,860 approaches that some of them that you've just 89 00:03:25,860 --> 00:03:26,360 described? 90 00:03:27,139 --> 00:03:29,060 Yeah. So what we've done now is we've 91 00:03:29,060 --> 00:03:32,360 compared to before where some other, iterations have 92 00:03:32,419 --> 00:03:34,599 tried to repurpose existing instrumentation 93 00:03:35,060 --> 00:03:36,919 in a way that was less than optimal, 94 00:03:37,355 --> 00:03:39,355 to try to help execute the subscap sparing 95 00:03:39,355 --> 00:03:42,235 approach. We've really changed and started from, you 96 00:03:42,235 --> 00:03:44,735 know, the beginning again and said, what instruments 97 00:03:44,955 --> 00:03:46,094 do we need to design, 98 00:03:46,635 --> 00:03:48,955 to try to make this, happen, in a 99 00:03:48,955 --> 00:03:51,294 more efficient and, reliable and predictable, 100 00:03:51,989 --> 00:03:54,489 manner. And so we've we've changed the instrumentation. 101 00:03:54,629 --> 00:03:57,590 We've changed retractors. We've designed retractors around this 102 00:03:57,590 --> 00:03:58,969 to help the surgeon, 103 00:03:59,750 --> 00:04:02,629 gain what, you know, visualization they need. We've 104 00:04:02,629 --> 00:04:03,129 changed, 105 00:04:03,430 --> 00:04:05,430 as I mentioned, we used to do subscap 106 00:04:05,430 --> 00:04:07,844 sparing mainly with just stemmed implants and using 107 00:04:07,844 --> 00:04:10,405 the interventricular canal. And now we've we've changed 108 00:04:10,405 --> 00:04:11,365 and altered that to, 109 00:04:12,485 --> 00:04:15,145 kinda meet the mark, in the current utilization 110 00:04:15,284 --> 00:04:17,845 of of stemless implants. And so being able 111 00:04:17,845 --> 00:04:20,805 to accurately reproduce, we place a stemless implant 112 00:04:20,805 --> 00:04:21,544 on the humerus, 113 00:04:22,189 --> 00:04:24,029 is is the other, one of the other 114 00:04:24,029 --> 00:04:24,850 key features. 115 00:04:25,629 --> 00:04:27,230 The last thing that I will say that 116 00:04:27,230 --> 00:04:28,370 I think is a real, 117 00:04:28,910 --> 00:04:31,310 game changer, for those that have tried subscap 118 00:04:31,310 --> 00:04:31,810 sparing, 119 00:04:32,430 --> 00:04:34,189 they'll tell you that the most challenging part 120 00:04:34,189 --> 00:04:35,810 of the procedure is how you manage 121 00:04:36,185 --> 00:04:38,425 the humerus. And and the the the instruments 122 00:04:38,425 --> 00:04:40,425 that I've mentioned where we can now more, 123 00:04:40,745 --> 00:04:41,884 timely and efficiently 124 00:04:42,345 --> 00:04:44,264 perform a humeral head cut without taking the 125 00:04:44,264 --> 00:04:46,425 subscap off or place the humeral implant more 126 00:04:46,425 --> 00:04:49,490 reproducibly are key steps. But the kind of 127 00:04:49,490 --> 00:04:51,810 maybe well, one of the bigger, changes is 128 00:04:51,810 --> 00:04:54,209 we've we've developed a mechanism by which we 129 00:04:54,209 --> 00:04:56,949 can access the glenoid through a transhumeral approach. 130 00:04:57,250 --> 00:04:58,769 So we don't need to move the humerus 131 00:04:58,769 --> 00:04:59,889 out of the way and retract it. We 132 00:04:59,889 --> 00:05:01,574 can just go right through the humerus, which 133 00:05:01,814 --> 00:05:03,915 opens up the the the realm of possibilities 134 00:05:04,215 --> 00:05:05,995 of what types of glenoid 135 00:05:06,535 --> 00:05:08,074 pathology we can manage, 136 00:05:08,615 --> 00:05:10,694 because it it, you know, it it improves 137 00:05:10,694 --> 00:05:12,395 our ability to access the glenoid, 138 00:05:13,175 --> 00:05:16,439 in a way that doesn't rely just exposure 139 00:05:16,439 --> 00:05:17,800 and some of the other factors out of 140 00:05:17,800 --> 00:05:18,459 our control. 141 00:05:18,759 --> 00:05:20,680 So I I think it's it's been a 142 00:05:20,680 --> 00:05:23,000 really rewarding experience to work with the design 143 00:05:23,000 --> 00:05:24,220 team and try to understand, 144 00:05:24,839 --> 00:05:26,680 what problems do we identify by leaving the 145 00:05:26,680 --> 00:05:28,620 subscap on and how do we design instruments 146 00:05:28,995 --> 00:05:31,415 and and leverage the implant of the intact 147 00:05:31,714 --> 00:05:33,334 to be able to execute that. 148 00:05:34,115 --> 00:05:35,555 I wanna jump back to something that you 149 00:05:35,555 --> 00:05:36,915 just touched on. You talked a little bit 150 00:05:36,915 --> 00:05:39,014 about the glen and your marrow piece here. 151 00:05:39,634 --> 00:05:42,160 When you see a patient that has glenoid 152 00:05:42,160 --> 00:05:45,120 meridural joint pain specifically, how do you determine 153 00:05:45,120 --> 00:05:47,060 whether that subscap sparing technique 154 00:05:47,520 --> 00:05:50,339 like Intact is appropriate for that patient? 155 00:05:51,120 --> 00:05:51,620 So, 156 00:05:52,240 --> 00:05:54,879 currently, my my surgical indications are around, you 157 00:05:54,879 --> 00:05:56,914 know, patients who have routine, 158 00:05:58,095 --> 00:05:59,794 primary glenohumeral osteoarthritis. 159 00:06:00,175 --> 00:06:01,854 So it's just, you know, loss of cartilage 160 00:06:01,854 --> 00:06:05,294 in the glenohumeral joint. Their shoulder, otherwise, is 161 00:06:05,294 --> 00:06:07,454 is normal, and then they've got a rotator 162 00:06:07,454 --> 00:06:09,474 cuff that's attached and functioning well. 163 00:06:09,960 --> 00:06:12,139 They don't have a lot of extreme deformities 164 00:06:12,199 --> 00:06:14,600 with bone resorption or or anything like that, 165 00:06:14,600 --> 00:06:17,180 but they've got, you know, some routine osteoarthritis. 166 00:06:17,960 --> 00:06:20,600 With that, any any patient that fits within 167 00:06:20,600 --> 00:06:22,839 that category in my in my practice, I 168 00:06:22,839 --> 00:06:24,194 would consider this for. 169 00:06:24,835 --> 00:06:27,154 The the benefit of it is by by 170 00:06:27,154 --> 00:06:29,975 not detaching and then reattaching the subscapularis, 171 00:06:30,754 --> 00:06:33,074 the risks that are associated with that, like 172 00:06:33,074 --> 00:06:34,455 not healing the subscapularis 173 00:06:35,555 --> 00:06:36,455 drops substantially. 174 00:06:37,120 --> 00:06:38,879 And and in addition to that, I'm able 175 00:06:38,879 --> 00:06:40,560 to help my patient recover a little more 176 00:06:40,560 --> 00:06:41,620 quickly. And so, 177 00:06:42,000 --> 00:06:44,259 for any patient with run of the mill, 178 00:06:44,560 --> 00:06:46,100 glenoid humor loss or arthritis, 179 00:06:46,560 --> 00:06:48,240 I will consider that. I will say that 180 00:06:48,240 --> 00:06:50,000 we're early enough in the learning curve. There 181 00:06:50,000 --> 00:06:51,600 are some patients where it may be challenging. 182 00:06:51,600 --> 00:06:53,774 So for surgeons who are listening who might 183 00:06:53,774 --> 00:06:55,375 consider this in their own practice, I would 184 00:06:55,375 --> 00:06:57,535 say, you know, patients with a significant amount 185 00:06:57,535 --> 00:06:58,274 of glenoid, 186 00:06:58,654 --> 00:06:59,154 deformity, 187 00:07:00,095 --> 00:07:02,175 where they might be considering a reverse shoulder 188 00:07:02,175 --> 00:07:05,490 replacement or substantial amounts of osteophyte formation or 189 00:07:05,490 --> 00:07:07,650 bone spur formation on the humeral side that 190 00:07:07,650 --> 00:07:09,350 might be challenging to remove 191 00:07:09,730 --> 00:07:12,610 in a predictable way by working under the 192 00:07:12,610 --> 00:07:15,270 subscapularis, I think, would be some other considerations. 193 00:07:16,770 --> 00:07:18,770 You mentioned one important thing here, which is 194 00:07:18,770 --> 00:07:21,095 really key, I think, the learning curve. Right? 195 00:07:21,095 --> 00:07:23,194 I think that's hap that happens with every 196 00:07:23,254 --> 00:07:26,214 new procedure, every new technique that comes into 197 00:07:26,214 --> 00:07:28,454 the into the marketplace, into health care, whatever 198 00:07:28,454 --> 00:07:29,274 it may be. 199 00:07:29,735 --> 00:07:31,735 Can you walk us through what sort of 200 00:07:31,735 --> 00:07:34,615 your first few enhanced intact cases looked like 201 00:07:34,615 --> 00:07:36,939 for you? What was your experience there? What 202 00:07:36,939 --> 00:07:39,420 did recovery look like for your patients? What 203 00:07:39,420 --> 00:07:41,040 was that learning curve like? 204 00:07:41,500 --> 00:07:42,000 Yeah. 205 00:07:42,699 --> 00:07:44,699 I think that's really key to consider. And 206 00:07:44,699 --> 00:07:47,259 as I mentioned before, we really wanna make 207 00:07:47,259 --> 00:07:49,279 sure that as we're considering a new technique, 208 00:07:49,584 --> 00:07:51,185 we are trying to solve a problem for 209 00:07:51,185 --> 00:07:52,724 the patient to help their outcome, 210 00:07:53,264 --> 00:07:54,404 and we don't want to 211 00:07:54,784 --> 00:07:57,904 sacrifice any potential, you know, positive outcome just 212 00:07:57,904 --> 00:08:00,064 for a technique. And so I think what 213 00:08:00,064 --> 00:08:00,564 we're, 214 00:08:00,944 --> 00:08:03,104 what in my own experience with my learning 215 00:08:03,104 --> 00:08:05,610 curve, I focused on, number one, patients who 216 00:08:05,610 --> 00:08:07,310 don't have a lot of deformity where, technically, 217 00:08:07,370 --> 00:08:09,529 I have a clear understanding of the anatomy 218 00:08:09,529 --> 00:08:10,509 I'm working with, 219 00:08:11,290 --> 00:08:12,910 despite not taking the subscapularis 220 00:08:13,290 --> 00:08:15,050 off. And when I got started with this, 221 00:08:15,050 --> 00:08:16,649 I started with some of the first few 222 00:08:16,649 --> 00:08:18,330 steps just to kinda make sure I was 223 00:08:18,330 --> 00:08:20,735 comfortable. I had a low threshold to use 224 00:08:20,735 --> 00:08:22,414 more X rays in the in the Operating 225 00:08:22,414 --> 00:08:24,274 Room where I would check and double check 226 00:08:24,414 --> 00:08:26,034 what I was using with the instruments, 227 00:08:26,654 --> 00:08:27,935 and making sure that I was, 228 00:08:29,375 --> 00:08:31,854 you know, performing or executing the step as 229 00:08:31,854 --> 00:08:34,360 I would as I plan to. And so 230 00:08:34,360 --> 00:08:35,799 when I put a cutting guide up and 231 00:08:35,799 --> 00:08:37,480 I would before I made the humeral cut, 232 00:08:37,480 --> 00:08:38,759 I would check it with an x-ray and 233 00:08:38,759 --> 00:08:40,779 make sure it looks like, I would expect. 234 00:08:41,240 --> 00:08:43,799 Or before doing a final implant placement in 235 00:08:43,799 --> 00:08:45,720 the Operating Room, I would get an x-ray, 236 00:08:46,039 --> 00:08:47,959 rather than wait until the recovery area. But 237 00:08:47,959 --> 00:08:50,815 the nice thing about the intact enhanced technique 238 00:08:50,815 --> 00:08:53,054 is that during the learning curve, I I 239 00:08:53,215 --> 00:08:54,495 and I did this, but I would go 240 00:08:54,495 --> 00:08:56,335 as far as I felt the patient's anatomy 241 00:08:56,335 --> 00:08:57,695 would allow me to go and my my 242 00:08:57,695 --> 00:08:59,054 learning curve would allow me to go. And 243 00:08:59,054 --> 00:09:01,054 if at any point, if it became clear 244 00:09:01,054 --> 00:09:02,654 that it'd be better off to just take 245 00:09:02,654 --> 00:09:04,350 the subs cap off, I went ahead and 246 00:09:04,350 --> 00:09:06,269 I did that. By by starting out with 247 00:09:06,269 --> 00:09:06,850 the technique, 248 00:09:07,470 --> 00:09:09,809 you don't burn any bridges to then just, 249 00:09:10,110 --> 00:09:12,429 your bailout procedure is what you've always done. 250 00:09:12,429 --> 00:09:14,190 And so I think that's a that's a 251 00:09:14,190 --> 00:09:16,029 key part in the early part of learning 252 00:09:16,029 --> 00:09:18,164 curve is give yourself permission to take more 253 00:09:18,164 --> 00:09:20,004 time in the Operating Room, get X rays 254 00:09:20,004 --> 00:09:22,404 in the Operating Room, and then realize that 255 00:09:22,404 --> 00:09:23,845 you can bail out to what you've always 256 00:09:23,845 --> 00:09:24,345 done, 257 00:09:24,644 --> 00:09:27,065 at any point, depending on your learning curve. 258 00:09:27,445 --> 00:09:29,700 Well and, again, it benefits the patient. It 259 00:09:29,700 --> 00:09:32,179 trickles down to the patient outcome, which is 260 00:09:32,179 --> 00:09:34,019 ultimately the biggest piece that you've mentioned. The 261 00:09:34,019 --> 00:09:35,540 patient is the central part of this. We 262 00:09:35,540 --> 00:09:37,860 wanna make it easier, which is so important 263 00:09:37,860 --> 00:09:38,840 for it. Yep. 264 00:09:39,620 --> 00:09:42,985 As more surgeons adopt these techniques, it's more 265 00:09:42,985 --> 00:09:46,285 widely adopted across different ASCs in the country. 266 00:09:46,745 --> 00:09:49,725 What do you think the future of anatomic 267 00:09:49,865 --> 00:09:51,404 shoulder shoulder atherplasty 268 00:09:51,785 --> 00:09:53,884 will will look like with that subscapularis 269 00:09:54,504 --> 00:09:55,404 sparing innovation? 270 00:09:56,519 --> 00:09:59,320 Yeah. As we as we continue to, proceed 271 00:09:59,320 --> 00:10:01,399 down our learning curve and and see how 272 00:10:01,399 --> 00:10:04,360 patients, you know, can recover more quickly, get 273 00:10:04,360 --> 00:10:06,600 back to work more quickly, and and we 274 00:10:06,600 --> 00:10:09,180 don't have to concern ourselves with the subscapularis 275 00:10:10,040 --> 00:10:12,225 healing after surgery, I think we're gonna see, 276 00:10:12,464 --> 00:10:14,304 I think, more of a demand, on the 277 00:10:14,304 --> 00:10:16,384 patient's side. And I've had some patients already 278 00:10:16,384 --> 00:10:18,065 come to my office, and they need a 279 00:10:18,065 --> 00:10:20,065 shoulder replacement. They'd ask, can you do this 280 00:10:20,065 --> 00:10:22,464 without taking off the rotator cuff? Because they 281 00:10:22,464 --> 00:10:24,704 they they understand, and they've read, and and 282 00:10:24,704 --> 00:10:27,419 understand that it's a much shorter recovery period. 283 00:10:27,419 --> 00:10:29,759 It's less complication regarding the subscapularis. 284 00:10:30,460 --> 00:10:32,620 So I think we're gonna see more patient 285 00:10:32,620 --> 00:10:35,419 demand. We're going to see more surgeons learning 286 00:10:35,419 --> 00:10:37,340 and needing to become more comfortable with the 287 00:10:37,340 --> 00:10:39,360 technique as far as the differences in surgical 288 00:10:39,419 --> 00:10:39,919 exposure. 289 00:10:40,524 --> 00:10:41,804 But I do see I see that it's 290 00:10:41,804 --> 00:10:42,544 gonna become, 291 00:10:43,325 --> 00:10:45,664 a bigger part of our practice more generally. 292 00:10:45,965 --> 00:10:48,205 The interest is high from the patient perspective, 293 00:10:48,205 --> 00:10:49,485 and I think we can make a good 294 00:10:49,485 --> 00:10:51,325 use case for it. I do think with 295 00:10:51,325 --> 00:10:53,804 innovation and technology, we probably will see a 296 00:10:53,804 --> 00:10:56,659 continued evolution of the instrumentation we have. So, 297 00:10:56,659 --> 00:10:59,299 you know, as as more digital guidance or 298 00:10:59,299 --> 00:11:02,339 navigation opportunities become available, we might see that 299 00:11:02,339 --> 00:11:03,779 help us with some of the steps that 300 00:11:03,779 --> 00:11:06,419 we've designed instruments around, and and that will 301 00:11:06,419 --> 00:11:08,659 only help us become more efficient and more 302 00:11:08,659 --> 00:11:10,980 accurate and precise as we work. But I 303 00:11:10,980 --> 00:11:11,684 do see, 304 00:11:12,085 --> 00:11:14,664 us you utilizing more surgeon technological 305 00:11:14,965 --> 00:11:16,264 aids as we move forward. 306 00:11:16,965 --> 00:11:19,605 And we did talk, specifically about the patient 307 00:11:19,605 --> 00:11:22,164 experiences in our first episode as well. If 308 00:11:22,164 --> 00:11:23,845 you've missed it for the audience, it is 309 00:11:23,845 --> 00:11:26,085 available on demand as well. Highly recommend you 310 00:11:26,085 --> 00:11:27,720 listen to that. Again, we talk quite a 311 00:11:27,720 --> 00:11:29,799 bit about the patient experience and and the 312 00:11:29,799 --> 00:11:32,200 expectations that patients have today, which is certainly 313 00:11:32,200 --> 00:11:35,159 critical to the these techniques and advancing these 314 00:11:35,159 --> 00:11:37,480 techniques. Doctor Chamberlain, it's so great to have 315 00:11:37,480 --> 00:11:39,320 you. Thanks again for taking some time and 316 00:11:39,320 --> 00:11:41,000 sharing your insights with us today. It's great 317 00:11:41,000 --> 00:11:42,695 to have you. Thank Thank you very much. 318 00:11:42,695 --> 00:11:44,455 Good to be with you, Lucas. Absolutely. And 319 00:11:44,455 --> 00:11:46,375 we also want to thank our podcast sponsor, 320 00:11:46,375 --> 00:11:47,975 DePuyis and Thies. You can tune in to 321 00:11:47,975 --> 00:11:50,774 more podcasts from Becker's Healthcare by visiting our 322 00:11:50,774 --> 00:11:54,075 podcast page at beckershospitalreview.com.