Danbury Hospital Surgeon Removes Lung Tumor In First Minimally Invasive Procedure

For the first time, a cancerous growth was removed from a patient’s lungs at Danbury Hospital during a new minimally invasive procedure, called a thoracoscopic lobectomy.

The two-hour surgery performed during the summer was highly successful, and the patient is doing well, said the surgeon, Michael Walker, MD, chief of the section of thoracic surgery in the Department of Surgery. Like other minimally invasive procedures offered by Danbury Hospital, the thoracoscopic lobectomy can decrease the length of hospitalization, while minimizing pain and shortening recovery time.

Pierre Saldinger, MD, chairman of the Department of Surgery, said that aside from renowned hospital centers in New York City, this highly advanced procedure for lung cancer is currently only available in Danbury and New Haven.

 “We have worked to build our cancer and other surgical expertise at Danbury Hospital, so that our region can be assured that safe high-quality surgical care is convenient,” Dr Saldinger said. “Minimally invasive surgery is helping a growing number of our patients recover faster and feel less pain than with traditional open surgery. It’s something an increasing number of our patients want.”

The thoracoscopic lobectomy, or video-assisted thoracic surgery (VATS), is like other minimally invasive procedures that use a laparoscope and video camera inserted through two or three small incisions.

A laparoscope is a thin, telescopelike instrument that is inserted through a small incision. The telescope is connected to a tiny video camera — smaller than a dime — that projects a view of the operative site onto video monitors located in the operating room. Additional small incisions are made near the telescope, through which the surgeon inserts specialized surgical instruments. The surgeon manipulates these instruments to perform the operation.

Some of the benefits of minimally invasive surgery versus traditional open surgery are less time in the hospital, faster recovery, decreased pain, and a smaller incision. Traditional surgery usually requires long, deep incisions and lengthy recovery periods. Minimally invasive surgery, also known as “keyhole” or “band-aid” surgery, shrinks the typical recovery time from six weeks to two or three weeks.

A thoracotomy, or traditional surgery to remove a lung tumor, involves opening the chest through a much larger incision and spreading the ribs, according to Dr Walker. The procedure, he said, can be quite painful and with the patient hospitalized for five or six days. The new procedure cuts hospitalization to three to four days.

While minimally invasive procedures had been used previously to biopsy a lung tumor or remove fluids, this is the first time the Danbury Hospital surgical team removed a lung tumor through a tiny incision, he said. VATS incisions are between one and two inches long. The incision in traditional surgery was about five to eight inches long.

While the thoracoscopic lobectomy is a huge advancement, not all patients with lung tumors are good candidates, according to Dr Walker. He estimates that about half of all patients with lung cancer will meet the criteria: the tumor has to be smaller than 3 inches and the cancer cannot have spread to any lymph nodes. In addition, the patient must not have had chemotherapy to help shrink the tumor prior to the operation. Patients with large tumors, cancer that has spread to the lymph nodes, and who have had chemotherapy prior to the operation will still have to the traditional open surgery, according to Dr Walker.

“This is the next advancement to the types of procedures we’re already doing,” said Dr Walker, who trained for VATS with leading doctors in the field at Duke University in North Carolina.

Some other minimally invasive procedures commonly performed at Danbury Hospital include orthopedic surgery (back, shoulder, knee, and hip); gynecologic surgery; removal of the gallbladder, pancreas, spleen, adrenal gland, kidney; colon surgery, including small bowel resection; liver surgery; gastrectomy; intragastric tumor removal; laparoscopic/endoscopic ultrasound; common bile duct exploration; hernia repair; surgery for achalasia and gastro-esophageal reflux disease (GERD); gastric bypass for morbid obesity; surgery for arterial aneurysms (endovascular stent graft); percutaneous radiofrequency ablation; prostate implants and prostate IMRT utilizing ultrasound to localize the gland; radiation and chemotherapy (presurgery) for rectal and colon cancer; laser bronchoscopy (endobronchial stent); sinus surgery, using image-guided technology; stereotactic radiobiopsy (breast); and plastic/reconstructive surgery.

For more information, call the Danbury Hospital Department of Surgery at 797-7345 or visit danburyhospital.org.