University of Iowa News Release
Aug. 29, 2003
UI Surgeons First To Remove Entire Esophagus With Surgical Robot
A University of Iowa Health Care team recently became the first in the world to completely remove a patient's esophagus and affected lymph nodes using the da Vinci robotic surgery system.
"This procedure marked the first time that a surgical robotic system was used to remove an entire cancerous esophagus and the associated lymph nodes all during a single surgery," said Kemp Kernstine, M.D., associate professor (clinical) in the UI Department of Surgery. "Because that nodal tissue can often harbor cancer cells, we believe that this approach may reduce the recurrence of the patient's tumors and may possibly improve survival."
The surgical team made 11 very small incisions to insert special instruments and a video camera, as well as a two-inch long incision in the neck. That approach compares with the traditional technique of making much longer incisions in the chest and abdomen. Physicians say the minimally invasive technique provides better visibility and wider dissection.
The patient went home only eight days after the surgery, compared to the 10- to 21-day stay that is typical after the more invasive traditional approach. Physicians say a minimally invasive surgery also causes less pain and permits a faster return to normal activities, such as work.
Other UI members of the groundbreaking health care team included: Daniel Berg, M.D., assistant professor of internal medicine; John Buatti, M.D., professor and head of radiation oncology; Javier Campos, M.D., Gerald Clamon, M.D., professor (clinical) of anesthesia; Dany Shamoun, M.D., assistant professor (clinical) of internal medicine; and nurses James Blayer, Mary Snyder and Mary Yoder.
The da Vinci system allows a surgeon to operate without actually putting his or her hands on the patient. Instead, after establishing access into the body cavity, the physician sits at a computer console that offers a three-dimensional view of the area to be treated with magnification up to 12 times that of normal vision. The surgeon uses joystick-like controls to manipulate long, narrow, specially hinged surgical instruments that are inserted through small incisions in the patient. The remote-controlled instruments can be used in hard-to-reach areas and turned in ways that would be impossible with normal wrist dexterity. Altogether, these advantages allow the surgeon to work on a smaller scale and more precisely than traditional surgery. Information about the system can be viewed online at www.uihealthcare.com/daVinci.
The device currently is approved for use in surgeries in the abdomen, pelvis and chest. In addition, UI Hospitals and Clinics is the first medical center in Iowa to use the da Vinci system to perform urological procedures, such as radical prostatectomy for removing a cancerous prostate and pyeloplasty for obstructed kidneys.
University of Iowa Health Care describes the partnership between the UI Roy J. and Lucille A. Carver College of Medicine and UI Hospitals and Clinics and the patient care, medical education and research programs and services they provide. Visit UI Health Care online at www.uihealthcare.com.
STORY SOURCE: Joint Office for Planning, Marketing and Communications, University of Iowa Health Care, 200 Hawkins Drive, Room 8798 JPP, Iowa City, Iowa 52242-1009.
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