South Nassau Communities Hospital

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South Nassau in the Community

06/24/2011

da Vinci Robot Assisted Bilobectomy is Performed for First Time on Long Island


A team of surgeons at South Nassau Communities Hospital using the da Vinci® Surgical System recently performed Long Island’s first robotic-assisted bilobectomy lung surgery . The procedure is used to remove cancer that involves two lobes of the lung.

A team of six expert physicians collaborated on the operation: Shahriyour Andaz, MD, FACS, South Nassau’s director of thoracic oncology; Alan Blum, MD, a specialist in pulmonary and critical care; Stewart Fox, MD, FACS, cardiothoracic surgeon; Arun Gupta, MD, internal medicine and specialist in cardiology; Evan Mair, MD, director of body imaging at South Nassau, and Kenneth Richman, MD, an interventional radiologist.

The surgery was performed on a 63-year-old female patient who was an active smoker with a history of coughing up traces of blood, a common symptom of lung cancer. The doctors ordered a CT-scan and biopsy which revealed a malignant tumor that straddled two lobes of the right lung. After closely examining the images of the tumor and its location and assessing the patient benefits of robotic-assisted bilobectomy as compared to a thoracotomy, the team reached a unanimous decision to perform bilobectomy with the da Vinci® Surgical System.

A thoracotomy is a major invasive operation in which the surgeon opens the chest cavity to remove part or all of a lung. To perform thoracotomy surgery, the surgeon makes a long incision on the side of the chest between the ribs. The ribs are spread apart so the surgeon can see into the chest cavity, and occasionally it is necessary to remove a piece of rib in order to allow the surgeon to remove the cancer. Most patients are hospitalized for at least 10 days following a thoracotomy and need two to four months to achieve a full recovery, although some people do return to most of their normal activities within six to eight weeks.

To complete the bilobectomy using the da Vinci, Drs. Andaz and Fox needed to make only four small incisions in the chest which were used to insert a small scope and pencil-thin robotic assisted surgical instruments. They used the instruments first to carefully and precisely dissect major blood vessels that lead from the heart and enter the lung. Then they separated two lobes of the right lung from the bronchus, trachea and the heart, and removed the lung cancer. The patient’s postoperative recovery was swift and without complications and she was discharged from South Nassau four days later.

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.

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. Over this time period, the number of da Vinci systems installed in the United States grew by approximately 75%; with estimated growth of 35% in the number of procedures in 2010 compared to 2009.

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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