First Robotic Lobectomy Performed at Memorial
Patients can now benefit from a minimally invasive robotic-assisted surgery technique performed locally at Memorial Hospital Belleville. Previously, patients who needed this surgery would have to travel to St. Louis.
Dr. Bryan Meyers, MD, MPH, a world-renowned thoracic surgeon with Washington University Physicians of Illinois, Inc., performed the very first robotic-assisted lobectomy procedure at Memorial Belleville on January 18. He has performed another at Memorial since with more scheduled in the near future. He said offering this technique at Memorial is a big move in a positive direction.
“From a hospital perspective, the investment in a robotic device such as this is a huge step in improving the health of the hospital,” Dr. Meyers said. “It is nice for something like this to be a win-win for both the patient and the hospital.”
David McKay, age 73, was the first patient to receive the robotic-assisted lobectomy at Memorial. McKay said he had a spot on his lung for a number of years that started to grow a year and a half ago.
“Each time I had a CT scan, it would get larger,” McKay said. “It reached a point where it was about the size of my thumbnail, so my radiologist scheduled a biopsy. The spot couldn’t be biopsied because it was behind a rib, so I was referred to Dr. Meyers. After meeting him, he suggested a robotic-assisted procedure to remove and test the tumor.”
Dr. Meyers said McKay’s symptoms and scans made his case preferable to a robotic procedure.
“He had evidence of stage 1 lung cancer without any signs of scar tissue that would obliterate the space between the lung and ribcage making the robotic procedure possible,” he said.
In speaking with Dr. Meyers, McKay mentioned that he and his wife are from Belleville. Dr. Meyers then decided to perform the first robotic-assisted lobectomy procedure at Memorial Belleville.
“My wife was thrilled that she would not have to drive back and forth to and from St. Louis, so we scheduled the surgery,” McKay said. “Surgery lasted a little over three hours. The tumor was removed and sent to pathology where it came back malignant, so my lower lobe was removed along with a number of lymph nodes. The reports came back showing no sign of cancer in my lymph nodes.”
McKay said he received exceptional care from all Memorial staff and nurses who cared for him post-op on the 2 North/NE nursing unit.
“It got boring for me because I felt really good,” he said. “I had no pain after surgery. Even after I got home, I didn’t have pain. The more I am able to move around, the better my breathing gets. I saw Dr. Meyers 19 days after surgery and was given a clean bill of health. I will have to have a CT scan every six months for a year, but that is all. I am very fortunate that this was caught in its very early stage. I expect a full recovery and will return to all activities in the near future.”
Dr. Meyers said he has also experienced the excellence and positive demeanor of Memorial staff.
“It has been a great pleasure working with the operating room team at Memorial while we prepare these operations,” he said. “It has been great to see the pride the OR team has taken with the initial successful outcomes. There will be many more to come.”
Jennifer Range, RN, first assistant in the operating room, has worked at Memorial for 23 years and said she had to complete additional training to assist with these specialized robotic procedures.
“In order to assist in robotic surgery, one must obtain their surgical first assistant certificate followed by training in the robot room,” Range said. “The first assistant courses vary in length and require logging hours of hands-on training prior to being awarded your certification. Surgical first assistant courses also require RNs to have their certification in perioperative nursing (CNOR) prior to signing up.”
Range said she was a support/extra circulating nurse for McKay’s robotic lobectomy and that her duties change only slightly for robotic procedures.
“I work as an RN first assistant, circulator, scrub and open-heart team where I hop in to assist, if necessary,” she said. “My role doesn’t change much with robotic procedures. The hand-eye coordination is different when using laparoscopic instruments and looking at a screen. There is a little bit more autonomy, communication and trust between you and the surgeon. When the surgeon is at the robotic console, you are taking instruments in and out per their request, help trouble shoot at the surgical field and help with visualization through an assist port, if there is one.”
She said it’s a great addition to Memorial to have a surgeon who can perform robotic assisted thoracic procedures.
“Prior to this first robotic assisted lobectomy, all the robotic and open-heart team members had an in-depth in-service about the case with robotic equipment representatives. “The reps had a lot of knowledge about the procedure, how Dr. Meyers performs his procedure and what to do if an emergency arises.”
Dr. Meyers said he began using robotic-assisted technology with lobectomies a few years ago alongside open and video-assisted thoracoscopic (VATS) lobectomies.
“Initially, the VATS procedure was considered minimally invasive,” he said. “However, development of the robot technology led to robotic-assisted lobectomy operations. Several years ago, building on many years of experience with open lobectomy and many more years of experience with VATS, I began performing robotic-assisted lobectomies.”
Having this advanced technology at Memorial will prove extremely beneficial to patients in multiple ways according to Dr. Meyers.
“This is the most modern iteration of options for lobectomy, and since there are strong indications that it is superior in some ways to both previous versions, it is important for Memorial’s patients to have access to the most cutting-edge options,” he said. “This procedure could make the difference between offering surgery or not to a patient with other medical conditions. It could also make a difference to the rate of recovery and the rate of return to preoperative function in all patients.”
The robot is a system of three to four mechanical arms that hold and manipulate the surgical instruments, allowing the surgeon to work delicately inside the body. This allows the surgeon to make much smaller incisions, which leads to a multitude of benefits for the patient.
“When you compare a robotic lobectomy to an open lobectomy, there is a reduction in pain, reduction in dysfunction of the upper arm and shoulder, avoidance of major incisions, allows the patient to be discharged slightly sooner, and the procedure lends itself to excellent visualization and control of movement inside the chest,” Dr. Meyers said. “Compared to a more traditional VATS lobectomy, the differences are smaller, but they probably still favor robotic lobectomies for shortening the hospital stay and making a quicker recovery back to preoperative function.”
Dr. Meyers has a clinic in Shiloh at the Siteman Cancer Center where he sees patients on Mondays.