New minimally invasive surgery for lung cancer reduces post-operative pain

Generally, after traditional open-chest surgery for lung cancer, patients may experience a significant amount of pain and spend up to a week in the hospital followed by months recovering.

George Krzesinski, 58, of Lisle, experienced practically none of those post-operative difficulties after surgeons at Loyola University Medical Center in Maywood utilized minimally invasive robotic technology to remove a cancerous growth and later a large segment of his left lung in September 2009.

"I had my first surgery Wednesday night and by Saturday I was home. I was ready to go home Friday but they kept me another day as a precaution," said Krzesinski, who underwent his first surgery on Sept. 9, 2009, to remove a cancerous growth from his lung. "I can't say I had a lot of pain. That was very surprising."

Two weeks later, Krzesinski underwent a second surgery to remove the left lower lobe of his lung, and again his experience was the same. He has surgery late Friday and was back home Sunday morning.

"They used the same incisions," Krzesinski said. "The only time I took pain medication was at night in case I rolled over onto the incisions."

Each year, more Americans die from lung cancer than from any other cancer, according to the American Cancer Society. This year, more than 160,000 Americans are expected to die from lung cancer and 200,000 new cases will be diagnosed. Surgery still continues to offers patients the best chance for long-term survival and a cure, depending on the type, location and the stage of the tumor.

Unlike a traditional lobectomy, which requires a large incision and division of the muscles of the chest and spreading the ribs, the robotic procedure using the Da Vinci ™ Surgical System allows surgeons to perform the same surgical procedure through four small incisions, resulting in less pain and reduced loss of blood.

"It's the least invasive way to perform that surgery," said thoracic surgeon Dr. Robert Love, who performed Krzesinski's operation along with thoracic surgeon Dr. Christopher Wigfield. "More and more patients with lung cancer are going to be treated this way."

Robotic surgery for lung cancer is done thoracoscopically, in which a tiny camera is inserted through a small incision in order to give surgeons a three-dimensional view of the inside of the chest, which is very rigid and harder to operate on using traditional surgery. Working through three additional, small incisions, the surgeon controls every move of the robotic arms from a computer console at the patient's bedside. The robot's arms are fully articulated, allowing it to turn and grasp with more agility and precision than the human hand.

"The total injury to the chest wall is far less with smaller and separated incisions. We're able to remove cancerous tissues and lymph nodes for further examination from any location in the lungs," Love said. "The chest wall returns to its normal flexibility faster and the function of the remaining lung recovers more quickly."

Love said the removal of the lymph nodes allows physicians to determine how much the tumor has spread from its original source.

"Proper staging is important in determining treatment and prognosis," Love said. "It tells us how to treat them afterwards and what to expect for treatment planning for the next five years until they are cured."

Traditional surgery for lung cancer generally requires a five to seven day stay in the hospital after the procedure. Recovery can take between eight to 12 weeks. The hospital stay after a robotic procedure is usually three to four days. Also, although most robotic procedures take about the same amount of time as traditional surgery, recovery is closer to three to four weeks since patients don't have to care for a large, incision.

"Patients can definitely recover more quickly and get on with further therapy quicker when necessary," Wigfield said.

Always a very active person, Krzesinski said he was up and walking about in only a few days after his surgery.

"We have a pond across the street with a path of about a third of a mile around. I was walking around that two, three days later," Krzesinski said. "I've been going to the health club. I've been biking. I've been going on the treadmill and incline. The robot is great. If you have to do it, that's the way to do it."