South Nassau Communities Hospital

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South Nassau in the Community

02/23/2011

Surgical Robot Assists in Lung Cancer Surgery


South Nassau Communities Hospital’s robotic-assisted surgery program recently performed its first robotic lobectomy for early-stage lung cancer. The procedure was performed by a multi-disciplinary team of physicians that included Shahriyour Andaz, MD, FACS, South Nassau’s director of thoracic oncology; Alan Blum, MD, specialist in pulmonary and critical care; Stuart Fox, MD, FACS, cardiothoracic surgeon; Arun Gupta, MD, cardiologist and specialist in internal medicine; Evan Mair, MD, director of body imaging at South Nassau, and Kenneth Richman, MD, an interventional radiologist.

The lobectomy was performed on a 68 year-old patient who was initially being treated for anemia, when she was diagnosed with colon cancer. The patient was scheduled for surgery and during pre-surgical testing a chest x-ray was taken that showed a lesion in the left lung. A subsequent positive emission tomography scan (PET/CT) revealed a ‘positive’ lesion (which means that the PET/CT, which is used to detect metabolically active cells in the body, showed that the lesion was active, increasing the likelihood that the lesion was cancerous) in the upper left lobe of the lung.

Wire localization (a technique that is used to mark the location of an abnormal mass that is small, or that can't be easily located by visual surgical instrumentation) was performed by Dr. Richman to enhance the surgical team’s access of the lesion. Using the da Vinci robotic surgical system, Drs. Andaz and Fox carefully separated the lobe of the lung from the blood supply being pumped into it by the heart. Then they resected the lobe by surgically interrupting the bronchus of the upper lobe.

To complete the surgery, Drs. Andaz and Fox needed to make only four small incisions in the chest to insert a small scope and pencil-thin robotic assisted surgical instruments. The scope provides a three-dimensional view of the surgical field on high definition monitors, while the surgical tools are used to remove the cancer. Traditional lung cancer surgery requires large incisions and can be debilitating and painful. Surgeons cut between the ribs in order to access the lung, leaving patients with a large incision on the side of the chest and a long post-operative recovery.

Robotic-assisted lung cancer surgery is most often performed on patients diagnosed with early-stage lung cancer, and studies prove that it is safe and effective. For example, a study of 100 patients who received robotic-assisted lung lobectomy concluded that robotic-assisted surgery is safe and effective for lung cancer, including mediastinal cancer, cancer in the lymph nodes of the lung, and pulmonary vascular dissection. Published in the August 2009 edition of the Journal of Thoracic Surgery and conducted by robotic-assisted surgeons at George Washington University Medical Center in Washington, DC, the study reported zero intraoperative deaths, no local recurrence of disease, an average surgical time of 216 minutes and length of hospital stay of four days.

The number of robotic-assisted procedures performed at hospitals around the world has increased from 80,000 in 2007 to 205,000 in 2009. Recognized as the world’s most advanced robotic surgical technology, the da Vinci received its name in recognition and honor of Leonardo da Vinci, who invented the first robot and used incomparable accuracy and three-dimensional details to bring his masterpieces to life. In like fashion, the da Vinci Robotic Surgical System helps surgeons perform complex surgeries with refined dexterity, precision and control, through small incisions. In addition to the precision and control, benefits for surgeons include increased range of motion, enhanced visualization and improved access. Patient benefits of robotic-assisted surgery include a shorter hospital stay; reduced pain and risk of infection; less blood loss and scarring; fewer transfusions; faster post-operative recovery; and a quicker return to normal daily activities.

While robotic-assisted surgery is most commonly used to treat men diagnosed with early prostate cancer, Dr. Andaz and other South Nassau surgeons also use the da Vinci system to perform general urologic, gynecologic, kidney, chest and other minimally-invasive surgical procedures.



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